If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
If 10060 Incision and drainage of abscess and 11730 Avulsion of nail plate are performed on the same toe during the same session, can both procedures be reimbursed or is 11730 bundled into 10060?
CPT code 11730 would require a modifier to show it was separate from the I/D...different area...separate incision...etc.......HOWEVER- if the Surgeon removed the nail plate and did an I/D of the abscess located beneath then it can not be billed separately.
Thats my two cents.
I agree with MIUGU completely. This is the exact example in the NCCI Coding Manual on the CMS website on when a modifier 59 would NOT be indicated. The nail is considered a contiguous structure to the nail bed and surrounding structure.
If the abscess was at the proximal end of the toe, you may be able to apply a modifier 59 to the 11730.