Wiki Podiatry-Dr. does a debridement

[codelady]

Help! Dr. does a debridement on both feet. CPT code 11721 with modifier-59? Or does 11721 already say it's for 2 feet?

Thanks for any help!

CORRECTION: 11721 and 11055 when both are done on the same day, modifier -59 is used as per the CCI edits.

Thanks to all who answered and chimed in! Greatly appreciated.

 

[tammster]

The code, itself, indicates both feet.

 

[codelady]

In the past, the biller coded it with mod-59 and it was paid. But the correct way is by itself with no modifier?

 

[tammster]

Well, it may need the -59 modifier depending on what other services are performed (if the combination is listed on the NCCI edits)

But, if it's the only 'procedure' being performed - you don't need the -59. You may also need a Q modifier, if the LCD indicates that the systemic condition needs it.

 

[codelady]

I've been looking for the CCI edits on mcr website and the lcd coverage, but cannot find it. I worked with it before but can't remember.

Sorry about all the questions, but you have been very helpful and it's greatly appreciated.

Thanks
Margaret

 

[cgallimore]

Here are a few links on the MCR website for Podiatry Services and Routine Footcare. These are very helpful.

http://www.cms.hhs.gov/transmittals/downloads/B02091.pdf
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0707.pdf

Hope it helps!

 

[tammster]

And the CCI edits can be found at:

http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp#TopOfPage

 

[MarciaH]

I work for 3 podiatrists and I've never used a mod -59 with 11721.

 

[TammyHF]

Using a 59 modifier would be correct to show that the 11721 was a distinct procedural service from a different procedure. I believe you are mistaking the 59 modifier with the 50 modifier for bilateral procedure. Now if your podiatrist is only debriding 1 to 5 nails then procedure 11720 then.