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The hardship exception application for the merit-based incentive payment system’s (MIPS’) Promoting Interoperability category, which opened Aug. 6, is simple to complete, but make sure you’ve got the goods to justify your case in case CMS decides to audit your claim.
While CMS is mulling possible changes to current E/M documentation guidelines, practices must continue to operate under the complex rules of the 1995 and 1997 versions — and under threat of an audit from multiple agencies and potential revenue loss when specific elements are missed or overlooked.

Question: I’m having a challenge with same-day billing. Here’s my situation: The doctor performs an injection with fluoroscopy at the hospital in the morning and then the patient comes to the office for a follow-up on the same day. The doctor would like to bill both services, but I feel like I’m double-dipping. Can I report both? Any help would be great!


Question: A patient who steppad and cut herself on a piece of glass months earlier still complained of pain in the area, though the wound was healed. A CT scan showed increased density in the subcutaneous fat on the plantar aspect. Surgery revealed a large, thick, deep callus extending through the dermis down to the subcutaneous tissue and extensive scar tissue. These were excised but no foreign object was found. We’re using 28192 (Removal of foreign body, foot; deep) but is that correct — seeing as we didn’t actually find a foreign body?

There are 115 CPT codes accepted by Medicare that relate to the removal of a foreign body, and in 2016, the most recent year for which we have Medicare data, they were used only 491,376 times, with 18 codes being used fewer than 100 times, and 62163 (Neuroendoscopy, intracranial; with retrieval of foreign body) used zero times.


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