Medical Claims and Billing

February 6, 2010

Q Modifier Update

Filed under: Coding Tips — Tags: , — Coder @ 5:06 pm

More Q Modifiers were updated recently, make sure that your staff is up to date on the currently preferred to be reported when the physician is performing foot care. Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care.  

To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description:

Class A Finding:Nontraumatic amputation of foot or integral skeletal portion thereof

Class B Findings:Absent posterior tibial pulse
Advanced trophic changes such as (three of the following sub-categories qualify as one class finding): hair growth (decrease or absence), nail changes (thickening), pigmentary changes (discoloration), skin texture (thin, shiny), skin color (rubor or redness)
Absent dorsalis pedis pulse

Class C Findings: Claudication
Temperature changes (e.g., cold feet)
Edema
Paresthesias (abnormal spontaneous sensations in the feet, e.g., numbness, prickling, or tingling)
Burning

For proper use, be sure to place the Q modifiers to indicate class findings before modifiers LT (Left side) and RT (Right side). Additionally, not all carriers will require it but it is a good idea to include detailed documentation about the necessity of the foot care and tie in the use of the Q modifier.

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