1. A. By way of illustration, but not limitation, fragmentation of billing in Regulation .02B(3)(i), of this chapter, includes breaking the following general procedures into the following listed specific procedures:

   1. (1) Keller bunionectomy — a multi-step procedure, which may include any or all of the following:

      1. (a) Resection of medial eminence 1st metatarsal head;
      2. (b) Resection base of proximal phalanx;
      3. (c) Capsulotomy/capsulorrhaphy;
      4. (d) Z-plasty of extensor tendon; and
      5. (e) Sesamoidectomy.

   2. (2) Lesser metatarsal osteotomy — a multi-step procedure, which may include any or all of the following:

      1. (a) Tenoplasty;
      2. (b) Capsulotomy/capsulorrhaphy;
      3. (c) Osteotomy; and
      4. (d) Fixation.
2. B. Fragmentation of billing is especially egregious when the licensee bills for both the general and specific procedures.

Authority: Health Occupations Article, §16-205, Annotated Code of Maryland

Effective date: November 26, 1990 (17:23 Md. R. 2732)

Regulation .02B amended effective November 2, 2009 (36:22 Md. R. 1724); July 2, 2018 (45:13 Md. R. 668)