Wiki Mycotic nails

[leab173]

Has anyone else recently been getting denials from medicare when billing cpt 11721, stating they are non covered services based on the lcd policy l36404, even though the claims are being billed correctly and once i do a redetermination of that rejection it pays, but i am getting this for every single one and it seems ridiculous that i have to keep doing redeterminations for them to be paid.

 

[erjones147]

It took me a loooooooong time to figure out how to get nail trimming paid for by Medicare

1) I actually bill G0127

2) There has to be a Q7, Q8, or Q9 modifier

3) Requires a referring medical provider (not the podiatrist) and the date last seen by the MD