Can these codes be billed in the physician office? I am finding an old Medicare policy that states they are to be billed in the hospital, critical access hospital, rural health clinic, etc.
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Tag Archives: diabetic
Diabetic teaching/training
We are an OB/Gyn practice. When our OB patients are newly diagnosed with gestational diabetes, our Nursing Supervisor educates/trains them in dietary and medication, including insulin injections. She spends a minimum of thirty minutes. The practice would like to get reimbursed. Is that possible? What CPT code would we use and does anyone know if insurance will pay for this service?
Diabetic Shoes provided to a patient that is non-diabetic
Here is the scenario:
I have a patient that is non-diabetic. This patient has Medicare and has decided to purchase a pair of shoes from our practice. Once again, he is not a diabetic; however, the shoes that he picked are considered a diabetic equivalent shoe. Would I bill this self-pay patient with HCPCS- L3222 x 2 – RLTL as self-pay (statutorily non-covered code with Medicare) OR would I have to obtain an ABN and bill the shoes as A5500 with the GA modifier?
Basically, I am asking, is it appropriate to code as L3222 since the patient is non-diabetic and this HCPCS is for an extra-depth shoe? The shoe provided to the patient was Dr. Comfort – Ranger style – hiking boot.
Thanks!
Diabetic Eye exam (S3000) vs 92015
Hello all,
I am wondering if anyone had some documentation on when to code the diabetic eye exam S3000 vs 9201x for a patient that has diabetes and is coming in for a year eye exam. In the documentation that I am reviewing there isn’t much difference between a patient that doesn’t have a diabetes to a patient with diabetes.
Thanks,
Becca
Diabetic Shoe Measuring
We have a Nurse that does the measuring for shoes for diabetic patients. Normally, I would charge the A5500 "For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe" but the shoes are provided to the patients through a special program. Our facility does not pay for the shoes. What can I charge, if anything, for the measuring for the shoes? Can I charge a nurse visit (99211)? TIA.
Diabetic cystopathy
I am confused on how to code Diabetic cystopathy. Can someone point me in the right direction?
Diabetic counseling for OBs – payment outside the global package?
I’ve researched this quite a bit on the internet and AAPC forum. I’m hoping to find out if there is an OBGYN clinic who has been successful at receiving additional reimbursement for Diabetic counseling to an OB patient. Our OBGYN clinic would like to institute diabetic counseling to diabetic patients with the NP who is part of the OBGYN clinic. This would not be a service as part of their routine OB care, and would be scheduled specifically for counseling. I’ve seen options of waiting until the patient delivers and then billing an E&M if they exceed the routine 13 visits. I’ve also seen options for billing G0108 if 30 minutes of counseling is provided and billing that at the time of service. Another suggestion was bill and E&M with a -25 at the time of service. Anyone have success in billing one of these methods out of the OBGYN clinic?
Thank you
April Rader, CPC
Gangrenous diabetic toe removal
I’m coding for the podiatrist in our wound care office. We are an outpatient department of the hospital. He had a patient to come in that basically had a dead toe hanging on by a thread! He removed it with a few snips and that was it. I don’t feel I should use the CPT code for an amputation, but how else would you code it? The patient is a non-insulin dependent diabetic. Here’s the part in his dictation where he is talking about the removal of the dead toe.
"………..Her 2nd toe is completely dead and hanging off. It is full of necrotic tissue and purulence down within the foot. We talked about the fact that her toe was dead. Informed consent was signed. We pretty easily snipped off the couple fibers of tissue holding on the toe……….."
Any suggestions are welcome!
"………..Her 2nd toe is completely dead and hanging off. It is full of necrotic tissue and purulence down within the foot. We talked about the fact that her toe was dead. Informed consent was signed. We pretty easily snipped off the couple fibers of tissue holding on the toe……….."
Any suggestions are welcome!
Diabetic Education Classes
I am looking for guidance on proper billing for Diabetic Education classes which are currently being held at our facility. These classes are spearheaded by our Pharmacy department and have several speakers to include a physician who speaks on the medical ups and downs of the condition, a nutritionist who speaks on proper diet, a wellness coach who speaks on exercise and other ways to stay active and the 2 hour session is ended by the pharmacy who speaks about the different medication and how they effect lifestyle habits and encourages changes. We are currently billing a 99213 (because this class contains our established patients). Is there any other cpt coding choice which we could utilize to better capture this scenario? I do recognize that our Medicare does not cover the G code, therefore would place out to pt resp. The 99213 would, of course, would be responsible for copay & deductibe (if not met).
Any help would be greatly appreciated!
Diabetic Retinal Eye Exam-PCP office
Hello—
I work in a Primary Care office and my physician is thinking about purchasing the machine/software to perform diabetic eye exams. What would be the correct CPT code since it’s being done in the primary care office setting? We’re needing to check on reimbursement so I want to be sure I have the correct codes.
I would really appreciate any feedback if any of you have experience with this! Thanks in advance!!