Primary Care Coding Alert

Many carriers require physicians to append a modifier from the Q7-Q9 range when billing routine foot care.

Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician's claim, check out the following list of what Medicare and other payers include in each description: Class A Finding: Nontraumatic amputation of foot or integral skeletal portion thereof Class B Findings: Absent posterior tibial pulse

Advanced trophic changes such as (three of the following sub-categories qualify as one class finding): hair growth (decrease or absence), nail changes (thickening), pigmentary changes (discoloration), skin texture (thin, shiny), skin color (rubor or redness)
 
Absent dorsalis pedis pulse Class C Findings:
 
Claudication

Temperature changes (e.g., cold feet)

Edema

Paresthesias (abnormal spontaneous sensations in the feet, e.g., numbness, prickling, or tingling)

Burning

Note: Place Q modifiers to indicate class findings before modifiers LT (Left side) and RT (Right side).