Podiatry and DME Coding Changes and Guidelines for 2024

Medicare and other insurance carriers have specific guidelines for documenting, dispensing, and billing for Durable Medical Equipment. Numerous healthcare facilities face financial challenges due to inadequate DME management processes. New documentation guidelines for DME, along with Local Coverage Determinations for government payors like Medicare, outline the medical necessity criteria for reimbursement of these items. By understanding these requirements and establishing an efficient office process, healthcare facilities can turn DME dispensing into a profitable endeavor.

This webinar by industry expert, Lynn M. Anderanin, CPC, CPPM, CPMA, CPC-I, COSC, will provide an overview of the significant updates to CPT® in Podiatry for 2024. Lynn will discuss the current Medicare guidelines for Podiatry, ensuring attendees receive information applicable to their daily code assignment. Additionally, the session will cover the reasoning behind the new codes from the AMA's viewpoint, helping attendees understand code usage and compliance. Attendees will also receive the latest information on Medicare policies regarding foot care.

Webinar Objectives

This session aims to educate healthcare providers on the specific policies of Medicare and other insurance carriers regarding nail debridement, corn and callus treatment, flat foot, bunions, and other podiatric conditions. Attendees will learn the relevant CPT and ICD-10 codes to determine patient responsibility for services and understand the medical necessity and documentation requirements to pass audits by CMS or commercial carriers successfully. Addressing payment for services when patients do not meet medical necessity requirements is crucial for maintaining a successful, profitable practice. As these requirements can change, staying informed about current guidelines is essential.

Many healthcare offices are unaware of the rules and guidelines for providing therapy and dispensing Durable Medical Equipment (DME) to patients. This session will guide attendees through the step-by-step process of enrolling in the Medicare program for DME, assigning codes for billing, determining appropriate charges, and meeting documentation requirements. Additionally, strategies for managing inventory will be discussed.

Webinar Agenda

• Understanding of the rationale behind the CPT® code changes for 2024
• Claim denial for using codes that have been deleted and replaced with new codes
• Using revised codes that now have a different description due to changes
• Medicare guidelines that affect the Podiatry Practice
• Know what is needed to meet the Medicare Standard Documentation guidelines that recently changed
• Understand how to assign the appropriate codes for billing purposed
• Gain knowledge in the medical necessity requirements for DME
• Apply the Reasonable Useful Life of DME
• Use PDAC for items dispensed to Medicare patients

Webinar Highlights

• Revisions to the bunion code description for clarification.
• When do the Q modifiers need to be added to procedures related to foot care.
• Obtaining the appropriate treating physician information and reporting it on Podiatry claims.
• Looking at the payable diagnosis(es) codes for podiatry services.
• Review of the 2021/2023 E/M Guidelines as well as 2024 revisions
• Know what is needed to meet the Medicare Standard Documentation guidelines that recently changed
• Understand how to assign the appropriate codes for billing purposed
• Gain knowledge in the medical necessity requirements for DME
• Apply the Reasonable Useful Life of DME
• Use PDAC for items dispensed to Medicare patients

Who Should Attend

Billers, coders, physicians, podiatrist, nurses, nurse practitioners, surgery schedulers, collectors, insurance claims representatives, insurance claims processors, medical assistants, prior authorization specialists