Sunday, November 14, 2010

BIG NEWS for me & a Podiatry coding issue....

Big news I want to share… (and education too!)

I have received good news from the AAPC this week. I just have to share with all of my blog followers. I have been chosen to speak at the national AAPC conference in April of 2011. It will be held in Long Beach, CA. I will be presenting on the daVinici robotic assist device utilized in a variety of surgeries. This is a presentation that is near and dear to my heart, as the surgeons that I work with, show me what successes they have every day utilizing this incredible robotic system.

I presented this educational session at our local chapter meeting in Boise, and had some GREAT feedback. If you would like to have the opportunity to see my presentation in Long Beach, here’s a quick link to see what the AAPC has out on the website regarding the conference.

I have also submitted this presentation to AHIMA, and am hopeful that I will get the opportunity to bring this to the AHIMA national conference in Salt Lake City in October 2011. I’ve got my fingers crossed that they’ll pick it up too.

And now….. back to our educational blog……..

Tenotomy – Toe: Percutaneous vs/Open procedure codes.

I was coding podiatry op reports, and came across an issue from the podiatrist. He wanted me to code/bill for an “open” hammer toe tenotomy (code 28232) that was performed in the office.

When I reviewed the documentation, it was really a “percutaneous” hammer toe tenotomy (code 28010) that he performed and he noted it as such. He did the release of the tendon with a needle.

The key CPT notation between these two procedures is the “percutaneous” vs/the “incisional” modality in the provider’s documentation. Because the podiatrist stated he did this procedure “percutaneously” I was able to code/bill this correctly. If you are unable to determine how the procedure was performed, do not “guess” or “assume”. Query your provider, then have them amend or update the documentation to clarify the procedure prior to the billing of your claim.

Definition of both procedures are:

Code 28010 Tenotomy, percutaneous, toe; single tendon

“This procedure is performed to correct mallet or hammer toe. The physician makes a small percutaneous incision at the crease of the toe where the tendon is restricted. The tendon is released from the bone and the toe is straightened. The incision is sutured and dressing applied. “

Code 28232 Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)

“This procedure is often done for repair of hammer toe. A small incision is made on the crease of the toe on the bottom of the foot. The skin is reflected and the tendon is exposed. The tendon is released from its attachment site allowing the toe to extend. This is usually is accompanied by other procedures. The incision is closed with sutures and a soft dressing is applied. Report 28234 if the incision is made on the dorsal toe and the extensor tendon is released”

Thanks again for allowing me to share my experiences with you, and I hope that I get the opportunity to meet you in person in Long Beach! HAPPY CODING!

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