My understanding is that code 11720 is for 5 or less and 11721 is for 6 or more. Based on this info I feel if my docs does 7 toes I bill 11721 once. He is telling me I need to bill it 11721 x7 since he did 7 toes. Same for 11720 if he does 3 toes. Can someone clarify correct billing for this code (i.e. 11721 is inclusive whether doing 6 toes or 9 or you bill out each toe).
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Wiki 11720 and 11721
- Thread starter PCMOS
- Start date
mitchellde
True Blue
Your understanding is correct. 11720 is for toes 1-5 not 1-5 each so it may be billed with only 1 unit. The 11721 is for 6 or more not 6 or more each, so only 1 unit maximum.
CodingKing
True Blue
If in doubt download the MUE table and provide that to the physician. It will show max of 1 unit.
https://www.cms.gov/apps/ama/licens.../2017-04-01-MCR-MUE-Practitioner-Services.zip
https://www.cms.gov/apps/ama/licens.../2017-04-01-MCR-MUE-Practitioner-Services.zip