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A diabetic patient is referred to me for an evaluation by her PCP. The patient has no complaints other than that. Is this a billing service under Medicare if they have no complaints?

What is meant by a front-end rejection by my DME carrier (CGS)?

Not an everyday event - but I removed a toe ring that was stuck. There was no vascular or soft tissue damage. I found a code for ring removal for the finger. I would think that the finger code would not be appropriate.  Jeffrie C. Leibovitz, D.P.M.

There is valid and chronic concern about the cost to Medicare regarding the complications of falling. I have heard from the experts that the cost to taxpayer annually is $50 billion. The podiatry profession is of one the first lines of defense when it comes to assessing patients for fall risk. There is also an incentive to abide by the MIPS quality measure for assessing fall risk for any patient 65 year or older. There are companies that provide the STEADI questionnaire available in software programs that can be used in the office along with balance assessment. There isa CPT code that can be used, 97750 (15 min/unit will max MUE of 8 units) for the purposes of billing. I was just wondering how many times this code can be billed per annum on a particular patient that is being assessed for fall risk? Since patients are usually seen multiple times throughout the year in a podiatry office for foot care and their health/medications/etc. can change during the interim between visits which could increase their fall risk score. So, would be appropriate to evaluate these patients every visit and bill for the 97750 if all the required billing parameters are met?

I recently failed a surgical dressing TPE because my charts did not document the depth of the wound. I thought that ingrown toenails and warts would do well with special dressings. Your thoughts?

I recently dispensed surgical dressings to a Humana patient and all the claims were denied, because they considered part of the global service for the debridement I provided. What recourse do I have? My only thought is in the future to have patients only receive their post operative dressings on a post operative day, rather than on their date of surgical debridement. What do you suggest?

One of my patients showed me a new intriguing wound or incisional closure system. Is this something I can bill in addition to my surgery?

Can I use a tibial fracture orthosis for a non-tibial fracture, and can I add a soft tissue interface (below knee) L2820?

I have a question about shockwave therapy for Musculoskeletal indications (0101T) and for wounds (0512T). Are these covered by Medicare? What about private insurance? If these are covered now, how do I know if the coverage is pulled later on that I won't be subject to claw backs?

If a custom DME product, such as a Rx brace or diabetic therapeutic shoes/ inserts, are not picked up by a patient what is the recourse the provider has regarding billing? I understand that when a patient is deceased or there's been changes in deformity based on the initial DME product prescription that billing can be provided for invoice cost. But in this case, if the product is never picked up by the patient, what is the best practice for this situation? Can you bill the patient at all at a certain time frame, that is, 60 or 90 days of having the DME in the office and have already been invoiced by the vendor and yet have not billed insurance because it was not dispensed.

What is the proper code for taking a cast or bio foam or scan for a foot or ankle foot orthotic?

My question is this: when a provider is considering the use a of biologic the LCD if available or the required parameters under the product use guidelines must be followed. Not every wound requires a biologic wound graft. I get that, but what I do not get is whether or not there is an actual standard of care, local or national, that a provider must adhere to when using these grafts? Or should they just use their better judgement, clinical experience, morality and medical integrity rather than how much they can profit from performed wound care using biologics?