Podiatry Coding & Billing Alert

Question: We have a patient who has had both first nails removed and phenolized twice, and yet the nails have grown back. She has asked the podiatrist to repeat the procedure, considering the nail plates are not complete or as thick as normal. How should I report it?

South Dakota Subscriber

Answer: This would be a regular nail procedure, unless your podiatrist used a different type of procedure. The most common CPT used is 11750 (Excision of nail and nail matrix, partial or complete [e.g., ingrown or deformed nail], for permanent removal) permanent removal of part or total toenail. Don't use 11750 more than once per digit. According to Ingenix Coding Companion for Podiatry, 11750 "may only be reported once per digit. A partial excision -- even when the partial excision requires two incisions (medial and lateral aspects) -- of the nail does not count as two separate procedures."