Tuesday, September 8, 2015

ICD-10 It is almost here! What podiatrist need to keep in mind-don't lose yourself in the details!

The October 1st deadline is quickly approaching for ICD-10.  Of course the question we are all asking is- "am I ready?"  But the follow up questions are, "is my staff?", "is my billing company?", "is my coding person?"  The reality is none of us truly know.  Insurance companies have the upper hand on this one.  We can only try our best to be prepared but the absolute word of caution I have for you is, do not rely on anyone else other than yourself to know what you need to know.  As a podiatrist, you know you have to be a little more scrappy than the other specialties.  We know modifiers, as we have the craziest modifiers and are a modifier specialty in our procedure codes.  So you should not fear the new diagnosis codes that are followed by: A D G S for the trauma fracture codes for example.

After one week of billing you will remember easily that when seeing fractures these letters will trail your diagnosis:
  • A, Initial encounter for closed fracture
  • B, Initial encounter for open fracture
  • D, Subsequent encounter for fracture with routine healing
  • G, Subsequent encounter for fracture with delayed healing
I have struggled to the level of specificity that is truly needed for your claim to be considered clean.  If you bill 73630 for example, for x-rays right side for a right foot 2nd metatarsal fracture non-displaced, the exact code is S92.324A.  There is also a code of S92.301A that is fracture of metatarsal closed right foot that would most likely get this claimed covered for you as well, but none of us are exactly sure yet. On my superbill I did not included every fracture of every bone.  My recommendation is to have a cheat sheet for fractures of metatarsals laminated and put in your office and at every desk in your office where staff members sit. We have this cheat sheet available and included with our Podiatry specific ICD-10 Superbill.  This is available at our website at:

But at the end of the day, what you need to make sure you know how to bill inside and out is your most common diagnosis with your most common procedures.  Sure I see trauma, but I see a lot of plantar fasciitis, posterior tibial tendonitis, peroneal tendonitis, ankle sprains, ulcers and diabetic foot care.  I will tell you that these are clear and very straightforward for the most part in ICD10. We are all in this together and should not be overwhelmed by the bean counters. 

Good luck as October 1st, 2015 nears closer!

Michele McGowan, DPM

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