Billing and Coding: Routine Foot Care - R7- Effective November 28, 2021

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI), and 01312 (NV).

Effective Date: November 28, 2021
Summary of Article: Made the following updates to this article.

  • Changed the reference for coverage for symptomatic hyperkeratoses to the new Wound and Ulcer Care Local Coverage Determination (LCD) and associated Billing and Coding Local Coverage Article (LCA) L8902/A58565 effective 11/28/21 in Group 1 Paragraph.
  • Updated the statement “For treatment of painful mycotic nails, or onychogryphosis, or onychauxis, see Group 5” to include Group 6 too in the Group 1 Paragraph.
  • Clarified the statement regarding when to bill the asterisked diagnosis code L60.8 to read *L60.8 is to be billed with 11719 only if one of the systemic conditions from Group 2, 3 or4 below is present AND the patient does not have dystrophic nails" in Group 1: Medical Necessity ICD-10-CM Codes Asterisk Explanation.

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            Last Updated Mon, 29 Nov 2021 15:56:19 +0000