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Podiatry Coding & Billing Alert

Reader Question:

Include Class Findings in Onychomycosis Claim

Published on Wed Jul 25, 2012

Question: During his initial visit, a new diabetic patient (250.7x) complaining of foot pain had his feet examined. The podiatrist removed a callus from his right foot. The patient was shown to have onychomycosis, so the doctor debrided two nails on the left foot (TA and T1). The E/M code is 99203. How should I code this? Should I use modifier 25?Oklahoma SubscriberAnswer: Yes, you use modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service). You would attach modifier 25 to E/M code 99203 (Office or other outpatient visit...), which you should link to 729.5 (Pain in limb) and 250.7x (Diabetes with peripheral circulatory disorders).For the procedures, if billing Medicare, you will need to include the class findings Q7 (One class A finding), Q8 (Two class B findings), or Q9 (One class B and two class C findings). [...]
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