• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

CPT Code 11721

P

phillyfan536

Guest
Messages
1
We are billing a cpt code of 11721 with a Q9 modifier for medicare. We are using the following diagnosis code 250.60, 357.2, 110.1

We are not getting paid by medicare for these services. We also are making sure we put the Endocriologist NPI number or the Family Physician NPI number & the last date seen.


Is anyone else having this problem or anyone have any suggestions


thanks
 
Does the documentation support the nail fungus code? I only ask as I have run across thru audit a fair number of podiatry claims using the 110.1 code with no documentation of the mycosis. Can you give the documentation of the diagnosis for one of these?
 
make sure to review the LCD for 11721 it has all the information needed. 110.1 should be primary if the documentation supprorts this dx. Also make sure to use 11720 if only 1-5 nails are done and 11721 if 6-10 are done. Getting these paid can be difficult, but follwoing the LCD should help make it smoother.
 
You must log in or register to reply here.
Top