I am a “call it like ya see it” podiatrist. Every
time the subject comes up about billing for nail
care, I feel the need to offer a bit of caution.
No matter how “clean” you feel about NOT billing
Medicare for nail care, you can’t make general
statements about coverage without examining the
patient.
I personally know a podiatrist who got busted for
UNDER-utilization. He went into a nursing home
and told them he didn’t’ bill Medicare for nail
care and charged everyone a flat fee. He was a
Medicare provider, so this was a no-no. If your
patient qualifies for the care, you can’t tell
them they don’t.
A standard answer that, “Medicare doesn’t pay for
this service” is fraud. The patients have paid
for the insurance and deserves what the insurance
covers, nothing less. Don’t get caught mistakenly
telling your patient with diagnosed and treated
PVD that they aren’t covered. If there really is
a grey area, send them for vascular testing.....
from a vascular specialist... not YOU.
You may be surprised at how many undiagnosed
blockages you find and limbs you save. I have my
class findings labeled as such in a template in
my EMR. I go straight down the screen with every
patient, every time. When someone complains of
claudication pain...straight for non-invasive
studies they go.
Don’t be the one who misses something serious
while trying to make a point. If the tests are
all negative and the person has good circulatory
status, tell them. Most would rather hear the
good news that they have great circulation and
accept there good fortune with cash payment for
their nail care. I present it like, “Good news
and bad news”. I don’t lose many to that. I have
one guy who comes in every 2 weeks and pays
cash!!! That’s his choice. They want to know you
care... so daggumit... CARE!!
Karen Malley Banks, DPM, Thomasville, GA
kmbwwjd@rose.net
