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Foot Care

jencox

Contributor
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10
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I am new to podiatry and I am having a hard time understanding the use of Q modifiers.

For Medicare I have a podiatrist documenting treatment of mycotic nails. As far as I understand this can be a covered service when it is documented that there is a fungus as well as pain? You would not need the Q modifiers?

For the same patient a corn is debrided. The patient is on long term anticoagulants. Does this qualify as a systemic condition? If the podiatrist has the information for the physician seeing the patient for the anticoagulation to submit on the CMS form and the patient has been seen in the last 6 months is this covered? There is no documentation to support any class findings for the Q modifier? Are these needed for every systemic condition?

For non-medicare what is required to be able to code treatment of mycotic nails, trimming of nails or callouses?

As you can see I am confused! Any help would be so appreciated!
 

hag48125

New
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6
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Class findings are not needed for mycotic nails and pain.

I do not believe anticoagulants are covered under the LCD/NCD for medicare. If you feel its medically necessary you can bill it and when it denies file a redermination with notes as to why you feel its medically necessary but I have tried this in certain instances in the past and rarely win my case in regards to routine foot care as their guidelines are pretty clear.

The LCD for your state will be extremely helpful in deciding when you need the physician and date last seen. If there is an asterisk next to the dx you will need the physician. If there are 2 asterisks you will need the physician and date last seen every time the services are billed.

As far as commercial insurance goes each have their own guidelines. Websites are usually a good place to start or a phone call to verify if its covered under the patient's plan.

hope this helps.
 
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