Podiatry Coding & Billing Alert

Question: A patient had an ingrown toenail removed, but it was not a permanent removal. A digital block was performed for both an anesthetic and for postop pain. Should I use CPT® code 11730 or 11750? Would the digital block be considered inclusive? 

New York Subscriber

Answer: According to your description, you should use 11730 (Avulsion of nail plate, partial or complete, simple; single) because this is the code of choice when all or part of a toenail is removed. The physician numbs the site with a digital nerve block, and then separates the nail plate from the nail bed. Any bleeding is cauterized and the site is bandaged. Electrocautrey ablation is used to control bleeding. Any small wounds are restored with a simple repair. 

You will code 11730 for one nail removal. Code 11732 (…each additional nail plate [List separately in addition to code for primary procedure]) for each additional nail removal. Simple closure may be necessary. If the wound requires immediate reconstruction with local flaps, you can report that procedure separately.

Code 11750 is more appropriate when whole or partial nail matrix is involved in the procedure.

Nerve block is inclusive in the procedure and you can’t report it separately. Remember to justify the procedure with ICD-9 703.0 (Ingrowing nail).