July 11, 2019

Have you ever completed a templated note for an at-risk foot exam without rolling up the patient’s pant legs? If so, you could be putting your patient and your practice at risk.

In a plenary lecture during the APMA Annual Scientific Meeting (The National) in Salt Lake City on July 11, Jeffrey D. Lehrman, DPM, APMA Health Policy and Practice consultant, will explore simple steps that can add significant value to your patient interactions.

“Most of us can be doing a more thorough, more complete lower extremity dermatological exam,” Dr. Lehrman said. “There are many cases in which a patient is being followed by a podiatrist for their at-risk foot exams, and the podiatrist is documenting that there are no lower-extremity concerns. Then the patient goes to a dermatologist who finds a skin cancer on the back of their calf. Roll up the pant legs during every visit, and you’re likely to find growths that warrant photographing, measuring, tracking, and in many cases performing a biopsy.”  

From a patient-safety perspective, more thorough exams and biopsies mean you could save a life. From a risk-management and practice-management perspective, performing more biopsies may help you practice smarter medicine. “Too many doctors are racing from room to room trying to see as many patients as possible,” Dr. Lehrman said. He advises his colleagues to slow down and spend more time with each patient. “You can afford to take the extra five to eight minutes,” he said. Biopsies reimburse well and make your care more productive and valuable to the patient.

Dr. Lehrman will provide examples of growths that should be biopsied and will cover the various types of biopsies—shave, punch, and incision. He also will offer advice on coding for each. As of January 1, 2019, all the CPT biopsy codes changed. “I’ll go through all the new biopsy codes and documentation guidance,” he said.

For more information about coding for biopsies under the new guidelines, watch “What’s New? ICD-10 and CPT Codes for 2019,” a webinar recorded by Dr. Lehrman available at www.apma.org/webinars. Also be sure to listen to the APMA Podcast Foot and Ankle Coding series.