Podiatry Coding & Billing Alert
Always Check Your CCI Edits When Reporting Codes Together
Question: I billed 11721-59 and 11719-Q8 on a claim, but the 11721-59 came back as denied. Could you tell me why this happened? North Dakota Subscriber Answer: This is an excellent of example of why you must always check the Correct Coding Initiative (CCI) edits when billing codes together. If you were to check, you would see that an edit exists with 11719 (Trimming of nondystrophic nails, any number). Since 11721 (Debridement of nail(s) by any method(s); 6 or more) is a Column 2 code for 11719, this service is bundled into the code. Therefore, if you were to submit 11719 and 11721 together on a claim, only the 11719 service would be paid. Also, this particular edit cannot be broken with a modifier under any circumstances.
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