Billing and Coding: Routine Foot Care - R2

This coverage article has been revised and published for notice under contract numbers: 02101 (AK), 02201 (ID), 02301(OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).

Effective Date: June 29, 2020
Summary of Article: The following updates were made to this article.

  • Under the ICD-10 Codes that Support Medical Necessity Group 1 Paragraph, added the word 'painful' to the following statement "(For treatment of painful mycotic nails, or onychogryphosis, or onychauxis, see Group 5)."
  • Clarified the timeframe the patient must have seen their treating physician for the asterisked DX code in the ICD-10 Codes that Support Medical Necessity Group 2, 3 and 4 sections.
  • Added MLN Matters® Number: SE1113 and the SSA 1833(e) reference to the CMS National Coverage Policy section.
  • Added the following diagnosis codes to the initially missed in Group 3 to be consistent the other contracts within Noridian's Jurisdiction.
    • I80.251 - Phlebitis and thrombophlebitis of right calf muscular vein, and
    • I80.252 - Phlebitis and thrombophlebitis of left calf muscular vein.

Visit the Noridian Medicare Coverage Articles webpage to view the complete listing of locally hosted coverage articles and/or access the Active, Future, or Retired articles available in the CMS MCD.


            Last Updated Mon, 13 Jul 2020 17:49:10 +0000