Podiatry Coding & Billing Alert

Question: Is paring calluses (11055-11057) only covered every 10 weeks for Medicare, or is it covered with the same frequency as nails (11720 and 11721)?

AAPC Forum Participant

Answer: As 11055 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion), 11056 (… 2 to 4 lesions), and 11057 (…more than 4 lesions) would be part of routine foot care, billing them every 60 days would be considered allowable. Though individual payer rules may vary, the following services are considered routine by Medicare:

• The cutting or removal of corns and calluses — codes 11055 (Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion) through 11057 (… more than 4 lesions)
• The trimming, cutting, clipping of nails — code 11719 (Trimming of nondystrophic nails, any number)
• The debridement of nails — codes 11720 (Debridement of nail(s) by any method(s); 1 to 5) and 11721 (… 6 or more)
• G0127 (Trimming of dystrophic nails, any number)
• Other hygienic and preventive maintenance care, which includes cleaning and soaking the feet, using skin creams to maintain skin tone of either ambulatory or bedridden patients, and any other service performed in the absence of localized illness, injury, or symptoms involving the foot

Some payers will require these codes to be accompanied with certain diagnosis codes to be payable.