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#1
06-07-2012, 08:37 AM
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Medicare Class B Findings-Foot Care
I'm presently auditing podiatry notes for routine foot care. I understand most of the Class B findings, but the provider and I have a difference of opinion regarding "pigmentary changes". My impression is that it refers to changes in the skin of the foot and she thinks it refers specifically to the nails. I think that "nail changes" would cover any changes in the nail and is separate from pigmentary changes. I am using the same logic as ICD, that anything in parentesis is a non-essential modifier.
As we know Medicare is purposely vague when it comes to actual definitions, so I've been trying to read LCDs from different carriers. The only carrier who actual describes pigmentary changes as skin discoloration is Palmetto. All the others I found use the same wording as CMS. I'm new to podiatry so any help that I can get would be appreciated. I don't want to give incorrect information, but I do want to help her document correctly.
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Doreen Clark, CPC, CPMA Medical Auditing Specialist Integrated Physicians Management Services East Harftord. Ct 
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#2
06-11-2012, 03:40 PM
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As both a Certified Podiatric Medical Assistant and a CPC who has coded podiatric claims, pigmentary changes refer to changes in color of the skin. However to be sure, I asked two podiatrists for whom I do not work. They agreed.
Hope that helps.
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#3
06-12-2012, 07:50 AM
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Thank you so much for your reply. That's what I thought, but it's nice to have confirmation.
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Doreen Clark, CPC, CPMA Medical Auditing Specialist Integrated Physicians Management Services East Harftord. Ct
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