Wiki Toenail removal

Lorisvg

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I need help picking a CPT code for the following:

3. Toenail concerns. In November of 2010, underwent toenail extraction with
nail plate ablation of the left second toenail. Twice since that procedure, she has had a portion of the lateral edge of the toenail recur. Requests recurrent attempt at ablation.

Skin exam: Reveals some irritation to the lateral one-third aspect of the second left toenail bed. No toenail present. Self-removed toenail approximately 1 week prior.


PROCEDURE: Discussed risks, benefits, and alternatives to recurrent nail bed ablation procedure. Utilizing a cotton q-tip with phenol, the area in question on the second left toenail was ablated in standard fashion. Patient tolerated the procedure without difficulty.
 
Maybe 11750 "Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal"?
 
I need help picking a CPT code for the following:

3. Toenail concerns. In November of 2010, underwent toenail extraction with
nail plate ablation of the left second toenail. Twice since that procedure, she has had a portion of the lateral edge of the toenail recur. Requests recurrent attempt at ablation.

Skin exam: Reveals some irritation to the lateral one-third aspect of the second left toenail bed. No toenail present. Self-removed toenail approximately 1 week prior.


PROCEDURE: Discussed risks, benefits, and alternatives to recurrent nail bed ablation procedure. Utilizing a cotton q-tip with phenol, the area in question on the second left toenail was ablated in standard fashion. Patient tolerated the procedure without difficulty.

It appears all he did was put some chemical onto the nailbed, If this patient is in global I would not even charge for this, if the pateint is not in global I would only charge an office visit, he even says there is no nail, that patient removed nail; he does not specify in the documentation that he did a matrixectomy, he doesnt mention the matrix at all. The nail bed and the nail matrix are not the same thing, for 11750 you must destroy the matrix. You really cannot even use 11730 because he says there is no nail there, both these codes include removal of a nail. I am assuming that was the whole op report.
 
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