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Stephnaie Posted Mon 09th of December, 2013 17:36:34 PM

How do you code 11056 for a Medicare patient? Is there modifiers needed?

The first patient's diagnosis is 250.00 (diabetes) and foot pain.

The other patient has diabetic neuropathy and peripheral vascular disease.

SuperCoder Answered Mon 09th of December, 2013 17:57:28 PM

Your Medicare carrier may want Q modifiers attached to the 11056. Q8 is for Class B findings: Absent posterior tibial pulse; advanced trophic changes as evidenced by any three of the following: hair growth, nail changes (thickening), pigmentary changes, skin texture, skin color or Absent dorsalis pedis pulse. Q9 is used for Classs C findings: Claudication; temperature changes {eg. cold feet}, Edema; Paresthesias; Burning. If the patient has evidence of diabetes with peripheral neuropathy, but no vascular impairment, the use of class findings modifiers is not appropriate. This condition would be represented by ICD-9 codes 250.60-250.63 or 357.2.

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