Using Q Modifiers on Foot Care Claims

Make sure that you and your staff are up to date on using Q Modifiers as these were updated in 2007. Make sure you are getting the best reimbursements by using the currently preferred modifiers to be reported when the physician is performing foot care.

Modifiers Q7 (One class A finding), Q8 (Two class B findings) or Q9 (One class B and two class C findings) tell insurers why your physician is performing foot care. To determine which modifier applies to your physician’s claim, check out the following list of what Medicare and other payers include in each description:

Class A Finding:
Nontraumatic amputation of foot or integral skeletal portion thereof

Class B Findings:
Absent posterior tibial pulse

Advanced trophic changes such as (three of the following sub-categories qualify as one class finding): hair growth (decrease or absence), nail changes (thickening), pigmentary changes (discoloration), skin texture (thin, shiny), skin color (rubor or redness)

Class C Findings:
Claudication

Temperature changes (e.g., cold feet)
Edema
Paresthesias (abnormal spontaneous sensations in the feet, e.g., numbness, prickling, or tingling)
Burning

For proper use, be sure to place the Q modifiers to indicate class findings before modifiers LT (Left side) and RT (Right side). Additionally, not all carriers will require it but it is a good idea to include detailed documentation about the necessity of the foot care and tie in the use of the Q modifier.

View all Articles by: Melissa Clark, CCS-P