Many carriers require physicians to append a modifier from the Q7-Q9 range when billing routine foot care. Class A Finding: Nontraumatic amputation of foot or integral skeletal portion thereof Class B Findings: Absent posterior tibial pulse Class C Findings:
Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician's claim, check out the following list of what Medicare and other payers include in each description:
Advanced trophic changes such as (three of the following sub-categories qualify as one class finding): hair growth (decrease or absence), nail changes (thickening), pigmentary changes (discoloration), skin texture (thin, shiny), skin color (rubor or redness)
Absent dorsalis pedis pulse
Claudication
Temperature changes (e.g., cold feet)
Edema
Paresthesias (abnormal spontaneous sensations in the feet, e.g., numbness, prickling, or tingling)
Burning
Note: Place Q modifiers to indicate class findings before modifiers LT (Left side) and RT (Right side).