tintin
Contributor
pt is w/ Medical Mutual of OHIO (PPO), the modifier required for procedure 11750. Anyone know which Modifier I can use?? Thx
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Wiki Modifier for 11750
- Thread starter tintin
- Start date
OCD_coder
True Blue
One of the finger modifiers FA - F9 (or toe TA-T9), possibly.
Last edited:
britbrit852003
Guru
Any of the toe or finger modifiers.
Toes are TA-T9
fingers FA-F9
Toes are TA-T9
fingers FA-F9
mitchellde
True Blue
I found this from Medicare for coverage of this procedure; it is old and I am not sure if it is still applicable:
The presumption of coverage may be applied when the physician rendering the routine foot care has identified:
1. A Class A finding (Modifier Q7)
2. Two of the Class B findings (Modifier Q8); or
3. One Class B and two Class C findings (Modifier Q9).
In the absence of a systemic condition, Medicare covers debridement of the nail when the following criteria are met:
In the case of ambulatory patients there exists:
● Clinical evidence of mycosis of the toenail, (110.1) and
● Marked limitation of ambulation (719.7 or 781.2), or pain (729.5 or 703.0), and/or secondary infection (681.10 or 681.11) resulting from the thickening and dystrophy of the infected toenail plate.
The presumption of coverage may be applied when the physician rendering the routine foot care has identified:
1. A Class A finding (Modifier Q7)
2. Two of the Class B findings (Modifier Q8); or
3. One Class B and two Class C findings (Modifier Q9).
In the absence of a systemic condition, Medicare covers debridement of the nail when the following criteria are met:
In the case of ambulatory patients there exists:
● Clinical evidence of mycosis of the toenail, (110.1) and
● Marked limitation of ambulation (719.7 or 781.2), or pain (729.5 or 703.0), and/or secondary infection (681.10 or 681.11) resulting from the thickening and dystrophy of the infected toenail plate.