Podiatry Coding & Billing Alert

Question: A patient came to our office with five ingrown toenails. Our physician completed simple avulsion on both sides of TA and T5, and one side of T1. How should we file this claim with private insurance?

Arizona Subscriber

Answer: You'll start with 11730 (Avulsion of nail plate, partial or complete, simple; single). According to the descriptor, 11730 covers either all or part of the nail, so you don't need to indicate "bilateral" or "both sides" of a single nail. Include modifier 59 (Distinct procedural service) for the second and third toes your podiatrist treated. Report:

• 11730-TA (Left foot, great toe)

• 11730-T5-59 (Right foot, great toe)

• 11730-T1-59 (Left foot, 2nd digit).