missyah20
Expert
I am a little confused with the wording in part of this LCD and I am hoping that someone can clarify it for me.
Under the section "ICD-9 Codes that Support Medical Necessity" the first paragraph states:
"*When billing CPT codes G0127, 11055, 11056, 11057, 11719 the Q modifier always must be used to indicate that there are systemic conditions that will allow the service to be covered. When billing CPT codes 11720 or 11721 the Q modifier must always be used with ICD-9 codes in list one and list two."
Does this mean that the first set of CPT codes mentioned always need a Q mod and a systemic condition to be pd or are they payable with one of the first 4 dx codes listed (1101, 700, 7038, and 7039) w/o a Q mod?
Thanks in advance for the help!
Under the section "ICD-9 Codes that Support Medical Necessity" the first paragraph states:
"*When billing CPT codes G0127, 11055, 11056, 11057, 11719 the Q modifier always must be used to indicate that there are systemic conditions that will allow the service to be covered. When billing CPT codes 11720 or 11721 the Q modifier must always be used with ICD-9 codes in list one and list two."
Does this mean that the first set of CPT codes mentioned always need a Q mod and a systemic condition to be pd or are they payable with one of the first 4 dx codes listed (1101, 700, 7038, and 7039) w/o a Q mod?
Thanks in advance for the help!