In regards to the modifier's Q7,Q8 & Q9
The official descriptions can be found in HCPCS Level II manual. You may
also find information regarding the modifiers in the LCD and related article for routine foot care and debridement.
Here is some info. re: the modifier's extracted from the LCD & article (NGS contractor)
One of the modifiers listed below must be reported with codes 11055, 11056, 11057, 11719, G0127, and with codes 11720 and 11721 when the coverage is based on the presence of a qualifying systemic condition, to indicate the class findings and site:
Modifier Q7: One (1) Class A finding
Modifier Q8: Two (2) Class B findings
Modifier Q9: One (1) Class B finding and two (2) Class C findings.
NOTE: If the patient has evidence of neuropathy, but no vascular impairment, the use of class findings modifiers is not necessary. This condition would be represented by the ICD-9 CM codes listed in the table below under “ICD-9 Codes that are Covered”.
Class A findings
Non-traumatic amputation of foot or integral skeletal portion thereof
Class B findings
Absent posterior tibial pulse
Advanced trophic changes as evidenced by any three of the following:
1. hair growth (decrease or increase)
2. nail changes (thickening)
3. pigmentary changes (discoloring)
4. skin texture (thin, shiny)
5. skin color (rubor or redness)
Absent dorsalis pedis pulse
Class C findings
Temperature changes (e.g., cold feet)
Paresthesias (abnormal spontaneous sensations in the feet)
The presumption of coverage may be applied when the physician rendering the routine foot care has identified:
1. A Class A finding
2. Two of the Class B findings; or
3. One Class B and two Class C findings.
Hope this helps,
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