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Routine Foot Care Question

C

clbarry8033

Networker
Messages
52
State of Kansas

If a patient has a systemic disease (Such as DM), but doesn't meet any of the class findings, does the patient still meet medical necessity if they have mycosis of the nail and pain in bilateral feet?

The diagnoses would look something like this: B35.1, M79.674, M79.675, E11.9

I feel like the answer is yes, considering all beneficiaries without a systemic disease do not have to meet these findings.

Thanks!
 
Hopefully Helpful

The pain would be used as the qualifying code for use of CPT 11720 or 11721 without the need for the Q code. Also, use the diabetes as the secondary diagnoses
 
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