08/03/2018

Correct Coding for CPT Codes 10060, 11056 and 11721

Medicare Claim -Pt presented with an abscess in addition to routine foot care DX codes L02.611, I73.89, L84, M79671 and M79672 10060 59 de 11721 Q8xs bcef 11055 Q8 bdef-this line was not paid and we are unclear why. CO236 was stated as denial. When a patient comes in for routine foot care and also has another issue what is the correct coding with modifiers? Do we need to use modifier FY

In order for all three line items to be paid by Medicare, it should be coded in the following way:

• 10060 with DX L02.611, no modifiers
• 11056 with DX codes I73.89 primary, L84 secondary, with Modifier 59 or XU primary, followed by the Q modifier
• 11721 with DX codes B35.1 primary, I73.89 secondary, then pain, with Modifier 59 or XU primary, followed by the Q modifier

The corn/callus removal was denied because of use of the XS Modifier. Changing the modifier should unbundle the service as a corrected claim.