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Hi all!!
I'm brand new, so please bear with me if I ask stupid questions. Okay #1, I am a biller for a podiatry practice in SC. They do visits to senior centers, disabled centers, etc. While doing routine foot care, he also does exams and consults. I have tried to bill code 99304, but medicare has denied this, stating that only docs and/or nps can bill for such services. Is there another code that we can use that medicare will approve for exams at such facilities???

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As far as I know, for Medicare, the EM includes routine care (and visa versa) - you're most likely not going to be able to receive $ for both. You can try to have the routine care, if not covered, done for cash and bill an EM for additional consultation for a different Dx.

If you are getting the message back from Medicare re: wrong provider, then you are probably not matching your Diagnosis codes with your treatment codes.

I don't do routine care, but I know it's the same for any treatments I do. If you have a charge for an EM and for an injection but only one Dx code then you are not going to get paid for the EM (might not ANYWAY!)

Steve

In our office on Long Island, NY we use 99307 with 25 modifier -

I bill first (example) say 735.4 Hammer toe, and 735.0. (hallus valgus) even on initial nursing facility visits we use the subsequent code 99307 with 25 ....submit

Then we go back and do the nail codes: 110.1 onychomycosis, 729.5 pain in limb, and 443.9 (pvd) with just the 11721..... submit

Jane: