Podiatry Coding & Billing Alert

Question: Do we use the same CPT^® codes to report trimming and debridement of a patient’s nails?

Wisconsin Subscriber

Answer: No. When your podiatrist performs routine nail care for a patient, he will either trim the nails or perform a debridement. Since the two procedures are different, you will report different CPT^® codes.

Report trimming: When your podiatrist performs trimming of a nail, this shows he only shortened the nail length, and he did not perform any changes to the nail’s shape or thickness. When your podiatrist performs trimming, report the service with one of the following codes, depending on the nail’s condition:

• G0127, Trimming of dystrophic nails, any number
• 11719, Trimming of nondystrophic nails, any number.

Report G0127 if your podiatrist trims dystrophic or malformed nails, and report 11719 if your podiatrist performs routine nail care for a patient with healthy nails.

If your clinician performs routine nail care for a non-Medicare patient, your payer might want you to also report HCPCS Level II code S0390 (Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions [e.g. diabetes], per visit) along with 11719.

Report debridement: If your podiatrist removes an excessive nail structure to reduce the nail’s thickness or to correct excessive curvature of a diseased or dystrophic nail, report a debridement code instead of a trimming code. Your debridement code options are as follows, depending on the number of toenails your podiatrist treated:

• 11720, Debridement of nail[s] by any method[s]; 1 to 5
• 11721, … 6 or more.