|
E/M
|
E/M
|
|
99203 New patient visit
|
99212 Followup
|
|
Postop visit 99024 no charge visit
|
99213 Followup
|
|
99214 Surgical Consult
|
Time spent
• • •
|
|
Plan dictation free text
|
|
|
CDFE
|
CDFE
|
|
Injections
|
Injections
|
|
20550/20552 Injection
|
20550/20552
|
|
20550-Plantar Fascitis left
|
20550-Plantar Fasciitis right
|
|
20550 capsulitis left
• • •
|
20550 capsulitis right
• • •
|
|
20550 enthesopathy anatomy left
• • •
|
20550 enthesopathy anatomy right
• • •
|
|
20552 trigger point foot and ankle, left
• • •
|
20552 trigger point foot and ankle right
• • •
|
|
64632/64640/64455 Injection
|
64632/64640/64455
|
|
64632 medial calcaneal nerve left
|
64632 plantar fascitis right
|
|
64632 Neuritis (Neuroma) Left
|
64632 Neuritis (Neuroma) Right
|
|
64640 Neuritis and entrapment left
|
64640 Neuritis and entrapment right
|
|
64455 Mortons Neuroma) Left
|
64455 Mortons (Neuroma) Right
|
|
Injection Medicare
|
Injection Medicare
|
|
20550-MEDICARE-Plantar Fascitis left
|
20550-MEDICARE-Plantar Fascitis right
|
|
20550 MEDICARE capsulitis left
• • •
|
20550 MEDICARE capsulitis right
• • •
|
|
20550 MEDICARE enthesopathy anatomy left
• • •
|
20550 MEDICARE enthesopathy anatomy right
• • •
|
|
20600-20606
|
20600/20604/20605/20606 Injections
|
|
20600 MPJ Inj LEFT WITHOUT ultrasound
• • •
|
20600 MPJ Inj RIGHT WITHOUT ultrasound
• • •
|
|
20604 MPJ inj LEFT WITH ultrasound
• • •
|
20604 MPJ inj RIGHT WITH ultrasound
• • •
|
|
20605 Ankle Sinus tarsi inj LEFT WITHOUT ultrasound
• • •
|
20605 Ankle Sinus tarsi inj RIGHT WITHOUT ultrasound
• • •
|
|
20606 Ankle Sinus tarsi inj LEFT WITH ultrasound
• • •
|
20606 Ankle tarsi inj RIGHT WITH ultrasound
• • •
|
|
Flower Amnioflo Injection
|
|
|
Flower Amnioflo - RX
|
|
|
Flower Amnioflo Injection administered LEFT
|
Flower Amnioflo Injection administered RIGHT
|
|
Strapping
|
Strapping
|
|
Strapping foot pain/generic LEFT
|
Strapping foot pain/generic RIGHT
|
|
Achille's tendinitis LEFT
|
Achille's tendinitis RIGHT
|
|
Ensethopathy Strapping LT foot
• • •
|
Ensethopathy Strapping, right foot
• • •
|
|
Enthesopathy strapping LEFT
|
Enthesopathy strapping RIGHT
|
|
Hallux abducto valgus strapping LEFT
|
Hallux abducto valgus strapping RIGHT
|
|
Metatarsalgia LEFT
|
Metatarsalgia RIGHT
|
|
Plantar fasciitis strapping LEFT
|
Plantar fasciitis strapping RIGHT
|
|
Tailor's bunion strapping LEFT
|
Tailor's bunion strapping RIGHT
|
|
Strapping Tendinitis, LT foot
• • •
|
Strapping Tendinitis, right foot
• • •
|
|
Tendinitis strapping LEFT
|
Tendinitis strapping RIGHT
|
|
Strapping, toes, left
• • •
|
Strapping toes, right foot
• • •
|
|
Unna boot
• • •
|
|
|
DME
|
DME
|
|
AFO follow up
• • •
|
Hanger Script
|
|
Medicare Molded AFO receipt
|
Medicare Prefab AFO receipt
|
|
ABN FORMS
|
|
|
DME ABN $100-$1000 PATIENT MUST SIGN
|
ABN Blank
|
|
ABN Digital monitoring form
|
ABN Orpyx Custom insoles
|
|
ABN $500
|
Spanish ABN blank form
|
|
Night splint Rx
• • •
|
Night splint dispensing
• • •
|
|
L1902- Ankle Brace RX
• • •
|
|
|
L1902- Ankle Brace LEFT dispense
|
L1902- Ankle Brace RIGHT dispense
|
|
L1907 RX & Casting Commercial
• • •
|
L1907 Commercial Dispensed
• • •
|
|
L1907 Medicare RX & Casting
• • •
|
L1907 Medicare Dispensed
• • •
|
|
L1907 Follow up
|
L1907 break in instructions
|
|
LE Brace/Astro XO RX/Order
|
LE Brace/Astro XO dispensed
|
|
L1971- Ankle Brace RX
• • •
|
|
|
L1971- Ankle Brace LEFT dispense
|
L1971- Ankle Brace RIGHT dispense
|
|
Non pneumatic cam walker Rx
• • •
|
Non pneumatic cam walker dispensing
• • •
|
|
Pneumatic Cam Walker rx
• • •
|
Pneumatic Cam Walker -dispense
• • •
|
|
Rybo brace Post. Tib Rx & Casting Commerical
• • •
|
Rybo brace Post. Tib dispensing Commercial
• • •
|
|
Rybo brace Post. Tib Rx & Casting MEDICARE
• • •
|
Rybo brace Post. Tib dispensing MEDICARE
• • •
|
|
Rybo Brace Ankle Instability RX & Casting Commercial
• • •
|
Rybo Brace Ankle Instability Comnmercial Dispense
• • •
|
|
Rybo Brace Ankle Instability RX & Casting Medicare
• • •
|
Rybo Brace Ankle Instability MEDICARE Dispense
• • •
|
|
Bilateral Rybo Commercial
|
Bilateral Rybo Medicare
|
|
Moore balance brace Rx
• • •
|
Moore balance brace Dispensed
• • •
|
|
|
DME dispensed
|
|
L1950/L1951 Spiral AFO
|
L1950/L1951
|
|
L1950 Left Spiral AFO Dispense (commercial)
|
L1950 Right AFO Dispense (commercial)
|
|
L1950 Left Spiral AFO Medicare Dispense
|
L1950 Right Spiral AFO Medicare Dispense
|
|
L1951 LEFT Custom AFO Commerical (measured)
|
L1951 Right Custom AFO Commerical (measured)
|
|
L1951 LEFT Custom AFO Medicare (measured)
|
L1951 Right Custom AFO Medicare (measured)
|
|
L1951 Left Custom AFO Dispense (commercial)
|
L1951 Right Custom AFO Dispense (commercial)
|
|
L1951 LEFT Custom AFO Dispense (Medicare)
|
L1951 Right Custom AFO Dispense (Medicare)
|
|
Crutch Substitute--Insurance
|
Crutch Substitute--Cash
|
|
Kneewalker Agreement
|
|
|
Custom Crow Walker RX & Casting COMMERCIAL
• • •
|
Custom Crow Walker RX & Casting MEDICARE
• • •
|
|
Crow Walker LT (dispensed) COMMERCIAL
|
Crow Walker RT (dispensed) COMMERCIAL
|
|
Crow Walker LT (dispensed) MEDICARE
|
Crow Walker RT (dispensed) MEDICARE
|
|
TENS unit
|
|
|
Wearable Devices
|
Wearable Devices
|
|
Dispense of wearable device
|
|
|
99453/99454 16 day Setup
|
|
|
99457 Remote Physiological Monitoring every 30 days
|
|
|
99091 Collection of data only
|
|
|
Medicare Prefab AFO receipt
|
|
|
Shoes & Sandals
|
Shoes & Sandals
|
|
Mens Dr. Comfort Order Form
|
Womens Dr. Comfort Order Form
|
|
Anodyne Shoe Order Mens & Womens
|
|
|
Patient Shoe size & Width
• • •
|
Shoe Company
|
|
Diabetic Shoes dispensing
• • •
|
Shoe style and notes
|
|
Regular Diabetic inserts (A5512) DISPENSED
|
Orpyx Insoles Dispensed (A5514)
|
|
Orphyx Diabetic casting
|
|
|
Medicare Shoe receipt
|
Medicare Molded AFO receipt
|
|
Shoes-women orthopedic INSURANCE
|
Shoes-Men orthopedic INSURANCE
|
|
Shoes-womens shoes CASH
|
Shoes Mens shoes CASH
|
|
Dispensed womens shoes
|
Dispensed mens shoes
|
|
Sandals
|
|
|
Sandals-Plantar fasciitis Insurance
|
Healing Sandals-hallux limitus Insurances
|
|
Men's Sandals cash
|
Women Sandals cash
|
|
Dressing
|
Dressing/Compression
|
|
Coflex 1 inch
• • •
|
Coflex 3 inch
• • •
|
|
Multilayer compression dressing
|
|
|
Compression socks A6530
|
Compression socks (CASH)
|
|
Wound Care
|
Wound Care
|
|
|
|
|
Wound Care Products
|
Collegen Powder Only
|
|
Collagen Kit--15 day kit
|
Collagen Kit--30 day
|
|
Epifix Graft
|
Epifix
|
|
Epifix necessity
|
|
|
Epifix 4x4.5mesh BCBS
|
Epifix 4x4.5 mesh MEDICARE
|
|
Graphix Core 3x4 necessity
|
Graphix Core 3x4 MEDICARE
|
|
Graphix Prime 3x4 necessity
|
Graphix Prime 3x4 MEDICARE
|
|
Orthotics
|
Orthotics
|
|
Orthotic Agreement
|
ABN MEDICARE Temps
|
|
Spanish Orthotic Agreement
|
orthotics recommend
|
|
Casted for orthotics FED EMP
|
Orthotic cigna
|
|
Offload device: Temp orthotics cash
|
Off Load:Temp orthotic insurance
|
|
Casted for orthotics Post. Tib
|
Orthotic Fitting--INSURANCE
|
|
Orthotic adjustment
|
Orthotic Fitting--CASH
|
|
Orthotic break in instructions
|
Spanish Orthotic Breakin Instructions
|
|
Orpyx CASH casting
|
Orpyx CASH Dispensed
|
|
Casting for 2nd pair of orthotics
|
Orthotics cash 500
|
|
Orthotic followup
|
Orthotics recover
|
|
Custom AFO followup (rybo)
|
Supramalleolar brace followup (L1907)
|
|
Metatarsal pad added to LEFT orthotic
|
Metatarsal pad added to RIGHT orthotic
|
|
Procedures:
|
Procedures
|
|
11730 Avulsion
|
Avulsion 11730
• • •
|
|
Nail consent
|
Spanish Nail Consent
|
|
11732 Additional Avulsion
|
Additional Avulsion 11732
• • •
|
|
Nail consent
|
Spanish Nail Consent
|
|
Commercial 11750
|
Commercial 11750
|
|
Nail consent
|
Spanish Nail Consent
|
|
Post Ambulatory Shoe dispensed
|
Post Ambulatory Shoe refused
|
|
11750 Minor consent and instructions
|
|
|
11750 TA Commercial
|
11750 T5 Commercial
|
|
11750 T1 Commercial
|
11750 T6 Commercial
|
|
11750 T2 Commercial
|
11750 T7 Commercial
|
|
11750 T3 Commercial
|
11750 T8 Commercial
|
|
11750 T4 Commercial
|
11750 T9 Commercial
|
|
Post op nail instructions
|
Spanish Postop Nail proc instructions
|
|
Postop Nail Kit LEFT--BCBS ONLY!
|
Postop Nail Kit RIGHT--BCBS ONLY!
|
|
Postop Soaking instructions (For Nail kit only)
|
Spanish Postop soaking instructions
|
|
Medicare 11750
|
Medicare 11750
|
|
Nail consent
|
Spanish Nail Consent
|
|
11750 TA medicare
|
11750 T5 medicare
|
|
11750 T1 medicare
|
11750 T6 medicare
|
|
11750 T2 medicare
|
11750 T7 medicare
|
|
11750 T3 medicare
|
11750 T8 medicare
|
|
11750 T4 medicare
|
11750 T9-medicare
|
|
Post op nail instructions
|
Spanish Postop nail proc instructions
|
|
Biopsy
|
All Biopsy
|
|
Biopsy dictation
|
|
|
Nail Biopsy commercial
• • •
|
Nail Biopsy medicare
• • •
|
|
Biopsy consent
|
Post op proc instructions
|
|
Spanish Biopsy Consent
|
Spanish Postop proc instructions
|
|
Incision and Drainage of Abscess 10060
|
Incision and Drainage complex 10061
|
|
11400 Excisional Biopsy LT LEG < 0.5 cm
• • •
|
11400 Excisional Biospy RT LEG < 0.5 cm
• • •
|
|
11401 Excisional Biopsy LT LEG 0.6-1.0 cm
• • •
|
11401 Excisional Biopsy RT LEG 0.6 -1.0 cm
• • •
|
|
11402 Excisional Biopsy LT LEG 1.1 - 2.0 cm
• • •
|
11402 Excisional Biopsy RT LEG 1.1 - 2.0 cm
• • •
|
|
11420 Excisional Biopsy LT FOOT < 0.5 cm
• • •
|
11420 Excisional Biospy RT FOOT < 0.5 cm
• • •
|
|
11421 Excisional Biopsy LT FOOT 0.6-1.0 cm
• • •
|
11421 Excisional Biopsy RT FOOT 0.6 -1.0 cm
• • •
|
|
11422 Excisional Biopsy LT FOOT 1.1 - 2.0 cm
• • •
|
11422 Excisional Biopsy RT FOOT 1.1 - 2.0 cm
• • •
|
|
17250 Left cauterization of granulomatous tissue
• • •
|
17250 Rght cauterization of granulomatous tissue
• • •
|
|
Bleo Verruca Treatment
|
Corns/Callouses
|
|
Amniofix/Epifix Injections
|
Amniofix/Epifix Injections
|
|
Amniofix injection- rx
|
amniofix injection administered
|
|
Epifix micronized injection rx
|
Epifix injection administered
|
|
Post op
|
Post op
|
|
Post op (excludes nail procedure)
• • •
|
Nail postop
|
|
Post op #2 with weightbearing (excludes nail procedure)
• • •
|
Post op #3 with weightbearing (excludes nail procedure)
• • •
|
|
Suture removal
|
Gel Sheet & skin protectant
|
|
Orders
|
Orders
|
|
Additional studies
• • •
|
Radiology Comments
|
|
Radiology orders
• • •
|
Lab Comments
|
|
Indications for MRI:
• • •
|
|
|
Labs
• • •
|
Referral
• • •
|
|
General Instructions
• • •
|
Education
|
|
Labs and X-rays
|
Lab & Xrays
|
|
|
|
|
Physical Therapy In House
|
Physical therapy
|
|
Education Comments
|
General Instruction Comments
|
|
Physical therapy RX
• • •
|
Physical Therapy Custom Dictation
|
|
|
Therapeutic exercises performed
|
|
ENTH Left: Physical therapy with strapping performed today
|
ENTH RT: Physical therapy with strapping performed today
|
|
Teno Left: Physical therapy with strapping performed today
|
Teno RT: Physical therapy with strapping performed today
|
|
Physical therapy LT WITHOUT strapping performed today
|
Physical therapy RT WITHOUT strapping performed today
|
|
Patient Education
|
Patient Education
|
|
Patient Education Forms (see Google Docs)
• • •
|
|
|
Test Results
|
Test Results
|
|
Xrays reviewed
|
MRI reviewed
|
|
CT reviewed
|
Other test results reviewed
|
|
Surgical Consult
|
Surgical Consult
|
|
Surgical consult
|
Surgical Consult Bunionectomy
|
|
Surgical Consult Plantar fasciitis
|
Surgical Consult Neuroma
|
|
Referrals
|
Referral To
• • •
|
|
Office Products
|
Office Products
|
|
Amerigel Lotion
|
Amerigel Wound
|
|
PT bands
|
Dr. Jill's Pads
|
|
Urea 42%
|
Tensoplast
|
|
Biofreeze roll on
|
Biofreeze gel
|
|
Clear Nails Pro
|
Postop Nail Kit-CASH ONLY
|
|
CASH Post Ambulatory Shoe dispensed
|
MIscellaneous cash products
|
|
Precert
|
Precert
|
|
Pre-operative amniotic tissue plan
• • •
|
|
|
DME to Precert.
• • •
|
Procedures to Precert
• • •
|
|
Return to Office
|
Return to Office
|
|
Appointment needed for Patient:
• • •
|
Return time frame
• • •
|
|
Additional Notes Free text
|
NEXT VISIT:
• • •
|
|
|
NEXT VISIT Additional Info
|
|
Authorization Agreement
|
Acknowledgement of Services
|
|
DO NOT USE
|
|
|
DO NOT USE--DONE
|
DO NOT USE--DONE
|
|
Do Not Use--DONE
|
DO NOT USE--DONE
|
|
DO NOT USE--DONE
|
do not use--DONE
|
|
Epifix 5x5.5mesh BCBS --DONE
|
Epifix 24mm Medicare--DONE
|
|
Epifix 5x6 BCBS=-DONE
|
Epifix 5x6 MEDICARE--DONE
|
|
Epifix 24mm BCBS--DONE
|
Epifix 5x5.5 mesh MEDICARE--DONE
|
|
DO NOT USE---DONE
|
DO NOT USE---DONE
|
|
Epifix Epicord Graft 2x3 BCBS
|
Epifix Epicord 2 x 3 Graft MEDICARE
|
|
DO NOT USE
|
DO NOT USE
|
|
Biopsy of skin punch biopsy 11100
|
Skin biopsy shaved 11100
|
|
Nail debride (for non medicare)
|
Amerigel A6248 Left
|
|
Amerigel A6248 Right
|
LE Brace/Astro XO Rx/Order
|
