Routine Foot Care

​​​​​​​“I have a Medicare patient that has healed a neuropathic ulcer (L97.522, E11.62) at the plantar base of his 5th metatarsal. He needs paring of the hyperkeratotic tissue, frequently with hemorrhagic changes, every four weeks or he re-ulcerates at this location. Should this be coded as: CPT 11055 using a GY modifier every other visit? Debriding devitalized tissue CPT 97597 or am I evaluating and managing an ulcer CPT 9921X?”

“My practice involves a lot of routine foot care and I am looking for clarification. In using Q8 and Q9 modifiers, do you need to have atherosclerotic peripheral vascular disease (ASPVD) as a diagnosis? If so what’s the code to be used for general ASPVD? Modifier Q7 indicates that there has been an amputation. It is not necessary to have an ASPVD diagnosis in that scenario?”