Podiatry Coding & Billing Alert
Focus on This Toenail Scenario
Question: A patient presented with a big toenail that was torn almost completely away from the toe in an injury. The podiatrist performed a digital block and removed the entire nail to the matrix. What CPT® code should we report for this service? Virginia Subscriber Answer: What you describe is a complete, simple nail removal, so you should report 11730 (Avulsion of nail plate, partial or complete, simple; single). Despite the fact that the op note mentions removal to the nail matrix, you should not use 11750 (Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal). The 11750 procedure involves intentional destruction of the nail matrix for permanent removal of the nail, so that it won’t grow back. That might involve procedures such as phenol application or electrocautery to destroy the nail matrix. Tip: The 11730 nail-removal procedure includes the nerve block, so you should not report a separate code for the anesthesia.
Related Articles
Podiatry Coding & Billing Alert
- Fractures:
3 Tips Boost Your Calcaneal Fracture Coding Accuracy
Rely on 28406 for the percutaneous treatment of calcaneal fractures. When it comes to appropriately [...] - Tenotomies:
Thwart Potential Claim Disasters by Following This Tenotomy Advice
Look to 28010, 28011 for percutaneous tenotomies. According to your podiatrist’s medical documentation, the patient [...] - MPFS:
2019 MPFS Highlights Telehealth and Virtual Care Services
Don’t miss new codes G0513 and G0514. Due to the growing landscape of technology in [...] - You Be the Coder:
Study These Critical Care Rules
Question: I am new to coding. Can you help me understand what constitutes as critical [...] - Reader Question:
Understand how to Correctly Document HPI
Question: One of our physician assistants believes that if she has an extended history of [...] - Reader Question:
Stay on top of 60-Day Rule for CMS Overpayments
Question: We recently realized that our practice has received overpayments from CMS. Can you explain [...] - Reader Question:
Figure out Subtalar Arthrodesis
Question: To treat the patient’s degenerative arthritis, the podiatrist fused the subtalar joint of his [...] - Reader Question:
Focus on This Toenail Scenario
Question: A patient presented with a big toenail that was torn almost completely away from [...] - Reader Question:
Rely on E/M Code in this Case
Question: Using forceps and a needle, the podiatrist removed a splinter from a patient’s foot. [...]
