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Need clarification on 11730. Per our MAC FCSO LCD (L33833):Avulsion of a nail (CPT codes 11730 and 11732) involving separation and removal of the entire nail plate or a portion of nail plate (including the entire length of the nail border to and under the eponychium). A nail avulsion usually requires injected local anesthesia except in instances wherein the digit is devoid of sensation or there are other extenuating circumstances for
which injectable anesthesia is not required or is medically contraindicated.
Is required to go as far as the eponychium to report this code? The way we are interpreting this is, if the provider went that far it's still included in this code and nothing else to report but is not required to go to and under in order to report this code. In the explanation of the procedure in the Podiatry Coding Companion doesn't indicate the requirement to go to and under the eponychium, just that the provider avulses a nail partially or complete. (A nail plate is removed, either partially or completely. the affected area is dissected free and the nail plate is exposed. The nail is then cut free of the bed)
Thank you in advance.
which injectable anesthesia is not required or is medically contraindicated.
Is required to go as far as the eponychium to report this code? The way we are interpreting this is, if the provider went that far it's still included in this code and nothing else to report but is not required to go to and under in order to report this code. In the explanation of the procedure in the Podiatry Coding Companion doesn't indicate the requirement to go to and under the eponychium, just that the provider avulses a nail partially or complete. (A nail plate is removed, either partially or completely. the affected area is dissected free and the nail plate is exposed. The nail is then cut free of the bed)
Thank you in advance.