You Be the Coder:
11750 Answers Your Ingrown Toenail Removal Coding Quest
Published on Sat Jan 01, 2011
Question: A patient presents for a follow-up of an ingrown toenail. The podiatrist finds that the patient now has two ingrown toenails -- one on each foot. The podiatrist removes both from each toe and also did a silver nitrate cauterization. Should I report 99212-25?Answer: Yes. Besides coding 99212-25, you should bill 11750 (Excision of nail and nail matrix, partial or complete [e.g., ingrown or deformed nail], for permanent removal) appended by modifier 50 (Bilateral procedure).-Logic for E/M: Because the diagnosis is new to one toe, you could justify 99212 (Office or other outpatient visit for the evaluation and management of an established patient which requires at least 2 of these 3 key components: a problem focused history; a problem focused examination, and straightforward medical decision making; Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). The patient presents [...]