02/21/2024

Diagnosis Pointers for Billing Medicare for at Risk Footcare

when billing medicare for at risk footcare example E11.42 as the qualifying condition is that the 1st code you bill with #2 being L84 or is it reversed? Does it matter what order the diagnoses pointers are in?

It does not matter what diagnosis pointer is linked to the procedure. To meet medical necessity requirements for the diagnosis code, diabetes must be one of the four codes listed on the claim. Any additional codes, like corns, can be reported as well. The only way it will cause a denial is if the medically necessary diagnosis is listed on the claim but not linked to the appropriate procedure.