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Q7, Q8, Q9 and Trailblazer!!

  1. #1
    Default Q7, Q8, Q9 and Trailblazer!!
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    Can anyone out there who is contracted with Trailblazer please explain to me these modifiers? I know that the physician assigns them for vascular based diagnoses, however if the provider only lists 250.00 in addition to 110.1 (or whatever the primary code is) do they still need the Q code? I need Trailblazer's rules broken down in simple terms-please!

  2. #2
    I posted this to another person's question, thought it could maybe help you too...?

    [I]Our Medicare contractor (Trailblazer Health) has a Podiatry billing manual.

    Go to:

  3. #3
    Podiatry takes some research. Make sure you read the LCD plus this link.

    Class findings (Q7 modifier = one Class A finding):
    Non-traumatic amputation of foot or integral skeletal portion thereof.

    Class B findings (Q8 modifier = two Class B findings):
    Absent posterior tibial pulse.
    At least one pulse per foot must be absent.
    Absent dorsalis pedis pulse.
    Advanced trophic changes as evidenced by any three of the following:
    o Hair growth (decrease or increase).
    Three trophic changes = one Class B finding
    o Nail changes (thickening).
    o Pigmentary changes (discoloring).
    o Skin texture (thin, shiny).
    o Skin color (rubor or redness).

    Class C findings (Q9 modifier = one Class B finding + two Class C findings):
    Temperature changes (e.g., cold feet).
    Paresthesias (abnormal spontaneous sensations in the feet).

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