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Podiatry-Dr. does a debridement

  1. Default Podiatry-Dr. does a debridement
    Medical Coding Books
    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.

  2. Default
    The code, itself, indicates both feet.
    ~Ursula, CPC~

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

  4. Default
    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.
    ~Ursula, CPC~

  5. Talking
    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.


  6. #6
    High Point, NC
    Here are a few links on the MCR website for Podiatry Services and Routine Footcare. These are very helpful.

    Hope it helps!
    Cindy Gallimore, CPC, CENTC

  7. Default
    And the CCI edits can be found at:
    ~Ursula, CPC~

  8. #8
    Flint, Michigan
    I work for 3 podiatrists and I've never used a mod -59 with 11721.

  9. #9
    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.
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

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