Podiatry Coding & Billing Alert

Question: A podiatrist reconstructs the nail bed on a patient's left toe, and performs avulsion of the nail of the second digit of the right foot. How should I report it?

Answer: You would report the service with 11762-FA and 11730-59-T6. Remember, list modifier 59 (Distinct procedural service) first with the location modifier second.

Update: CPT 11762 (Reconstruction of nail bed with graft) now includes 11730 (Avulsion of nail plate, partial or complete, simple; single). These bundles allow separate reporting if clinically necessary, with the appropriate modifier appended to the component (Column 2) code. However, make sure these procedures would not be used together on the same site. Instead, they would have had to be performed on different nails.

You should use these HCPCS site modifiers in addition to modifier 59 when coding 11762 and 11730 separately:

• TA -- Left foot, great toe
• T1 -- ...second digit
• T2 -- ... third digit
• T3 -- ... fourth digit
• T4 -- ... fifth digit
• T5 -- Right foot, great toe
• T6 -- ... second digit
• T7 -- ... third digit
• T8 -- ... fourth digit
• T9 -- ... fifth digit.