Wiki Cpt and modifiers

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dcormier1

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I work for a Podiatrist, who is constantly billing 11719 Q8 with ICD-10 code E11.49 and 11720 59 Q8 with ICD-10 codes L60.2 and E11.19 together to Medicare replacement plans. The 11720 is constantly being denied. My question is, can these two codes be billed together or are they considered bundled? If they can be billed together please advise which modifiers can be used and if the DX codes are correct. Thank you.
 
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I don't think you mean E11.19. If you meant E11.9, that is your problem. The diabetes code that must be present with the L60.2 cannot be an uncomplicated code, which E11.9 is.

If you look up LCD/NCDs for routine foot care, I think you'll find what you need. There are more issues with those codes, including whether or not the patient has vascular impairment, for instance.
 
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SharonCollachi said:
I don't think you mean E11.19. If you meant E11.9, that is your problem. The diabetes code that must be present with the L60.2 cannot be an uncomplicated code, which E11.9 is.

If you look up LCD/NCDs for routine foot care, I think you'll find what you need. There are more issues with those codes, including whether or not the patient has vascular impairment, for instance.
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Thank you , Sharon! I did make a typo on the DX codes.
 
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Hi my name is Millie and I work for a Orthopedics:
Patient came in through the emergency 02/04/2020 and was admitted for surgery the same day. Discharged 02/05/2020. I billed 99285-57 25609 LT 25290-52 LT. ICD-10 was S52.572A. What POS would you use for the consult and for the surgery?
 
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