How do you bill for nail debridement?

If the toenails are documented as non-dystrophic or essentially “normal” toenails, the appropriate code to bill is CPT code 11719. If the toenails are documented as mycotic, the appropriate CPT code to bill based upon the number of toenails that are debrided is either CPT 11720 or CPT 11721.

What is debridement of a toenail?

Nail debridement involves removal of a diseased toenail bed or viable nail plate. This may be performed manually with an instrument, or with an electric grinder. Podiatrists generally provide nail debridement to patients diagnosed with onychomycosis (i.e., mycosis or mycotic toenails).

What is the difference between 11719 and 11720?

11719 applies when the nails are void of defects from nutritional or metabolic abnormalities. (in other words – healthy). 11720-11721 includes trimming and shaping of the nails as well as debridement.

What does CPT code 11720 mean?

CPT® 11720, Under Surgical Procedures on the Nails The Current Procedural Terminology (CPT®) code 11720 as maintained by American Medical Association, is a medical procedural code under the range – Surgical Procedures on the Nails.

What is the difference between nail debridement and nail trimming?

Nail debridement: the significant reduction in the thickness and length of the toe nail with the aim of allowing the patient to ambulate without pain. Nail debridement is a distinct service from “routine foot care” . Simple trimming of the end of the toenails by cutting or grinding is not debridement.

What is the CPT code for debridement?

For example, CPT code 11042 defined as “debridement, subcutaneous tissue” should be used if only necrotic subcutaneous tissue is debrided, even though the ulcer or wound might extend to the bone.

What is the CPT code for cutting toenails?

Answer: For nail trimming or clippings, the CPT code is 11719 – Trimming of nondystrophic nails, any number.

Can you bill G0127 and 11719?

CPT codes 11719, 11721 & G0127 should not be billed together to avoid inclusive denials If the insurance company denies the claim even when the modifier is billed correctly, CCI (Correct Coding Initiative) edits should be checked and appealed with appropriate medical records.

Is nail debridement covered by Medicare?

Medicare will cover debridement of nail(s) by any method(s); 1 to 5 and/or debridement of nail(s) by any method(s); 6 or more no more often than every 60 days.

What are podiatry CPT codes?

A podiatrist can also bill using CPT codes 97112 and 97032, but along with the GP modifier and documentation recorded aptly.

What is the difference between CPT 97597 and 11042?

1. Active wound care, performed with minimal anesthesia is billed with either CPT code 97597 or 97598. 2. Debridement of a wound, performed before the application of a topical or local anesthesia is billed with CPT codes 11042 – 11047.

What does CPT code 11042 mean?

11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less. +11045 – each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)

Does Medicare cover nail debridement?

How do you bill a toenail removal?

Definition: 11750: Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal; Lay Description: The physician removes all or part of a fingernail or toenail, including the nail plate and matrix permanently.

What is the CPT code for debridement of 10 nails?

When reporting debridement of mycotic nails (CPT codes 11720, 11721), the primary diagnosis representing the patient’s dermatophytosis of the nail must be listed, as well as the secondary diagnosis representing the systemic condition.

Does Medicare pay for toe nail removal?

The cutting of toenails in a healthy person or when they are not painful is not a payable service by Medicare. The cutting of corns and calluses in a healthy person is not a payable service by Medicare. Legally, your podiatrist cannot try to obtain Medicare payment for noncovered foot care.

What is procedure code 11721?

CPT® 11721, Under Surgical Procedures on the Nails The Current Procedural Terminology (CPT®) code 11721 as maintained by American Medical Association, is a medical procedural code under the range – Surgical Procedures on the Nails.

What does CPT code 11719 mean?

CPT® 11719, Under Surgical Procedures on the Nails The Current Procedural Terminology (CPT®) code 11719 as maintained by American Medical Association, is a medical procedural code under the range – Surgical Procedures on the Nails.

What is included in CPT 11042?

CPT codes 11042, 11043, 11044, 11045, 11046, and 11047 are used to report surgical removal (debridement) of devitalized tissue from wounds. Use appropriate modifiers when more than one wound is debrided on the same day.

What is the difference between CPT 11042 and 97597?

Is 11042 still a valid CPT code?

Other Pertinent CPT Coding Changes CPT codes 11040 and 11041. As I noted earlier, these codes have been deleted for all uses. CPT 11042. This code continues to address the debridement of wounds down to and including subcutaneous tissue.

Should thickened toenails be removed?

Toenails that grow thicker over time likely indicate a fungal infection, also known as onychomycosis. Left untreated, thick toenails can become painful. Prompt treatment can be key to curing the nail fungus. Fungal infections might be difficult to cure and may require months of treatment.