Medical Service


Podiatry is a branch of medicine that focuses on the diagnosis and treatment of diseases, injuries, and deformities of the human foot. The diagnostic, medical, and surgical treatment of problems of the foot, ankle, and lower extremity are all part of podiatric medicine.

With a systemic ailment, CPT code 11721 (Covered Nail Debridement 6 or More) requires a Q8 modifier (for routine check-up). Medicare will compensate you if this is medically required. However, this is only compensated six times per year.

T1 to T9 modifiers are commonly used with podiatry codes (Toe modifiers). Toe modifiers are not utilised for CPT codes 97598, 11720, or 11721.

Toe modifiers are not utilised for CPT codes 97598, 11720, or 11721.

Injection operations (HCPCS code J3301) and J1100 (injection procedures) are often utilized in Podiatry Billing and generate a large amount of revenue to physicians.

For the respective description, use the CPTs listed below.

CPT Descriptions
76881 Ultrasound, extremity, nonvasculat, real-time with image documentation
76882 Limited ultrasound, extremity, non-vasculat, real-time with image documentation
93922 Non-invasive physiologic studies of upper or lower extremity arteries, single level, bilateral
93926 Duplex scan of lower extremity arteries or arterial bypass grafts
20552 Injections(s), single to multiple trigger point(s) on or two muscle(s)
20553 Injections(s), single to multiple trigger point(s) three or more muscle(s)
20605 Arthrocentesis, aspiration, and/or injections
20610 Arthrocentesis, aspiration, and/or injections
CPT Descriptions
Physician Visits
99203-99204 Office Visits New Patient (Level 3 – Level 4)
99213-99214 Office Visits Established Patient (Level 3 – Level 4)
Nail care & Nail Procedures
11720 Toenail Trim (1 Foot)
11721 Toenail Trim (2 Foot)
11730 Toenail Removal
11750 Toenail Removal (Permanent)
97597 Debridement of Open Wound
17110 Wart or Lesion Removal up to 14 (benign)
L3020 Custom Orthotic Materials (OR002
29799 Casting Impression Fitting (S0395)
97760 Orthotic Management Training 15 Minutes each
Other In-Office Procedures
29405 Apply short leg cast (Non-weight Bearing)
Q4038 Short leg cast material
20550 injection Tendon Sheath/Ligament
J3001 Triamcinolone Acetonide (Typically 1 unit used)
L4360 Otto bock Pneumatic Walker (immobilizing Boot (SS406)
L4396 Foot Night Splint – Treatment for Plantar Fasciitis (SS397)
L1902 Ankle Brace (SS243)


The findings relevant to the patient’s condition are indicated by Q modifiers. Billing for podiatric services is done using the codes Q7, Q8, and Q9.

With procedure codes 11055, 11056, 11057, 11719, 11720, 11721, or G0127, Q modifiers may be used.

Modifiers Descriptions
Q7 One Class A Finding
Q8 Two Class B Findings
Q9 One Class B and Two Class C Findings

Class A:

·         Non-traumatic amputation of the foot or integral skeletal portion thereof

Class B:

·         Absent posterior tibial pulse

·         Absent dorsalis pedis pulse

·         Advanced trophic changes (at least three of the following):

·         Decrease or absence of hair growth

·         Nail thickening

·         Skin discoloration

·         Thin and shiny skin texture

·         Rubor or redness of the skin

Class C:

·         Claudication

·         Temperature changes (cold feet)

·         Edema If multiple surgical procedures are performed, append payable modifiers must be used before class finding Q modifiers, or the ten-digit toe modifiers (TA-T9), or the left or right foot modifier (LT, RT)

Major requirements while billing podiatry services:

1.       Inclusive CPT – CPT codes 11719, 11721 & G0127 should not be billed together to avoid inclusive denials

2.       Frequency – Routine foot care services are considered medically necessary once in 60 days

3.       Authorization – It is necessary to obtain prior authorization from the payer

4.       POS – A common denial problem with durable medical equipment (DME) is listing inappropriate places of service

5.       Insurance Verification – Podiatry claims get denied because of termination of coverage by the payer, the services provided are not being covered or the maximum benefit for Podiatry services has already been provided

For additional information, please contact us at +1440-209-5122 or