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Thread: Nail Debridement for Hospice Patient

  1. #1

    Default Nail Debridement for Hospice Patient

    AAPC: Back to School
    We bill for a podiatrist who sees patients in various nursing facilities. Among those patients are some in hospice. For a diabetic Medicare patient we are coding a 11720 or 11721 with the Q-modifier, GW modifier, PCP and date last seen by PCP.

    Medicare is flatly denying all of our nail debridements for hospice patients. Any help would be greatly appreciated!!

  2. #2
    Join Date
    Apr 2007
    Coastal Coders


    What dx's are you using?

  3. #3


    The diagnosis would need to meet medical necessity... I did a google search on "medical necessity for nail debridement" and this is what it gave me


    Try this "MCR Payments for Nail Debridement Services" this might help.

  4. #4


    We are using 110.1, 729.5 and 250.70 or 110.1, 703.0 and 250.70. Thanks for the question!

  5. #5


    For Hospice patients, you need to use GW and GV modifiers, then medicare will pay

  6. #6
    Join Date
    Apr 2007
    Honolulu, HI


    the dx order has to be 110.1, 250.60 or 250.70 for the 11721-Q?GW

    i know for Palmetto, the prim dx has to come from list A and secondary dx from list B in order to for the claim to be medically necessary. The dx order linkage on podiatry is extremely important

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