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cherylann.knighton

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HI!
We have a brand new Podiatrist! So gettin g my ducks in a row.
Can I bill 11720 and 11056 together.
And is this sufficient documenation? Thanks for your help.

Procedures
Debrided right hallux nail using sharp nail nippers in length.
Calluses were paired, right distal hallux and fifth digit using sharp curette. Patient tolerated the procedures well.
 
cknighton@fchn.org said:
HI!
We have a brand new Podiatrist! So gettin g my ducks in a row.
Can I bill 11720 and 11056 together.
And is this sufficient documenation? Thanks for your help.

Procedures
Debrided right hallux nail using sharp nail nippers in length.
Calluses were paired, right distal hallux and fifth digit using sharp curette. Patient tolerated the procedures well.
Click to expand...

Yes and No. you need to list 11056 on first line of claim and use the appropriate Q modifier. As this code range requires the Q code. Next list the 11720, less than 5 nails debrided. Be sure to list modifier "ES" indicating this was performed on a separate body part. This code should also have the Q modifier but when billed alone can go with out it. Also what DX codes are you using? Did you have the patient sign an ABN? frequently CMS won't cover podiatry services except under special circumstances.

As for the documentation I can suggest a couple of things from my experience. A description of the nail(s) is helpful. (elongated, thick, discolored, crumbling, mycotic) something that would suggest why this patient is not able to clip their own nails, including the use of anti coagulates. Type of callous is also helpful.
I have been coding and billing podiatry for the last 13 years. I would be glad to assistant you.
Debbie
 
11055/11056

This question is for Debbie,

I'd be greatly grateful if you could help me out here before I go crazy! I have tried every which way to get corn removal paid for by Medicare to no avail!

I use Dx codes 700 and 729.5. There really aren't any other codes I can use and most of the time I find that I can't get a Q modifier to cover it either. Don't the Q modifiers apply mostly to the toenails?
Is it better to use the X modifiers now? I can see getting denials when I am also coding 11721 for the nail trimming as it would seem that the corn is on a toe but there are many times the corn is somewhere other than a toe. And there are times when it is just a corn removal and no nail trimming. Not all, but a lot of these patients are very elderly with large painful corns on the bottom of their feet and they really need a doctor to remove them, but I just can't seem to get these paid. Do you use ABNs where you work?
I look forward to any input you could give me!
Thank you!
 
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