| Code | Description |
|---|---|
| 11057 | PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN 4 LESIONS |
| 11719 | TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER |
| 11720 | DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5 |
| 11721 | DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORE |
What does 11721 stand for?
Jun 09, 2020 · Generally, Q modifiers are required only for vascular-based ICD-9 codes. How often can 11721 be billed? Therefore, the following CPT codes should only be billed once within a two-month time frame: 11055-11057 (Paring or cutting of benign hyperkeratotic lesion). 11719-11721 (Trimming or debridement of nails). G0127 (Trimming of dystrophic nails).
What are CPT Modifiers and why we use CPT Modifiers?
Oct 01, 2015 · 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 …
Do medications have CPT codes?
Mar 11, 2020 · 7. The following class finding modifiers should usually be used with G0127, 11055, 11056, 11057, 11719, and when appropriate, CPT codes 11720, 11721. A Class A finding (Modifier Q7) Two of the Class B findings (Modifier Q8); or One Class B …
Is CPT 91110 covered by Medicare?
Dec 26, 2019 · 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 EXCEPT where the patient has evidence of neuropathy, but no vascular impairment, for which class findings modifiers are not required:
Does CPT 11721 need a modifier?
Is CPT 11721 covered by Medicare?
How often can you Medicare 11721?
What is the Q8 modifier?
Can 11721 and 11056 be billed together?
What does Q7 modifier mean?
What does Q9 modifier mean?
Can 11057 and 11721 be billed together?
What is Q9 modifier?
What is Medicare Q0 modifier?
What does modifier Q7 Q8 Q9 mean?
What is the ABN modifier?
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy.
Article Guidance
This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Routine Foot Care and Debridement of Nails.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
What is the CPT code for mycotic nails?
Coding for Mycotic Nails. Although CPT coding does not exclusively apply CPT codes 11720 and 11721 to mycotic nails or to the feet, Medicare assumes these are the CPT codes usually used to code for services related to debriding mycotic nails.
What is hygienic and preventive maintenance care?
Other hygienic and preventive maintenance care in the realm of self-care, such as cleaning and soaking the feet, the use of skin creams to maintain skin tone of either ambulatory or bedfast patients; Any other service performed in the absence of localized illness, injury, or symptoms involving the foot.
How often is foot care considered medically necessary?
Covered exceptions to routine foot care services are considered medically necessary once (1) in 60 days. More frequent services will be denied as not reasonable and necessary. The exclusion of foot care is determined by the nature of the service, regardless of the clinician who performs the service.
What is the treatment for keratoma?
Shaving, paring, cutting or removal of keratoma, tyloma, and heloma; Other hygienic and preventive maintenance care in the realm of self-care, such as cleaning and soaking the feet, the use of skin creams to maintain skin tone of either ambulatory or bedfast patients;
Does Medicare cover mycotic nails?
Medicare will cover debridement of mycotic nails as an adjunct to pharmacologic treatment with a prescription antifungal agent indicated per its Food and Drug Administration (FDA) label for the treatment of fungal nail infections.
What does "appropriate" mean in medical terms?
Appropriate, including the duration and frequency that is considered appropriate for the service, in terms of whether it is: Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member.
What is furnished in medical practice?
Furnished in accordance with accepted standards of medical practice for the diagnosis or treatment of the patient’s condition or to improve the function of a malformed body member. Furnished in a setting appropriate to the patient’s medical needs and condition. Ordered and furnished by qualified personnel.
