Wiki Chemical avulsion

[pattifrank]

A client has asked me the following question. I have no idea of the answer. Can anyone help?

"I have a billing and coding question that has came up recently. A patient presents with fungus of the toenail. Treatment provided is an application of urea paste. Is this considered a chemical debridement, chemical avulsion or neither?"

NCDs and LCDs did not address this question. Should it be content of service for an office visit? Can it be billed as 11730?

Patti Frank
pfrank@kc.rr.com

 

[Orthocoderpgu]

Full disclosure I code ortho surgeries and have not had any experience with this specific procedure before. In doing some research the urea paste is applied and left on for 7-10 days to soften the nail. Then the patient returns to have the diseased portion of the nail removed. The diseased portion would probably be removed via debridement. It seems the urea application would be included with the E/M.

 

[podcoder70]

I am a podiatry coder, 20+ years. This would be an e&m. If the nail is debrided in thickness and length, you can bill 11720. A 11730 is Avulsion of nail plate, partial or complete, simple; single. 11750 is Excision of nail and nail matrix, partial or complete. What you describe is neither of those codes.