Forum - Questions & Answers

Nov 5th, 2020 - sharris

Nail Debridement vs Nail Trimming

I have a documentation and reimbursement question and hoping you can clarify?

"All the nails were trimmed in length with a sterile nail nipper. The leading edges were debrided with the nail bur and electric podiatry drill. The debris under the edges of the great toenails was derided with the sterile curet"

Is this nail trimming since we DID NOT debride the entire nail (just edges and under toe)? CPT 11719
OR
Does it not matter as long as a portion was debrided Can we bill as 11721?

Thanks

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Nov 12th, 2020 - ChrisW   187  1 

re: Nail Debridement vs Nail Trimming

It depends, are the nails mycotic? Or are they healthy non dystrophic nails?

11720 debridement of 1-5 mail(s) by any method...
11721 debridement of 6 or more

The above codes are reported when removing the diseased nail bed or plate, usually, due to a mycotic (Fungal) infection on a diabetic patient, it is trimmed then debrided using a scapel, a file or drill or grinder. it is then smoothed, and topical antifungal medication may be used.

11719 - Trimming of non-dystrophic nails, any number, used for reporting one or more non-dystrophic nails that are trimmed and shaped using nail cutters or scissors.

Find-A-Code has a lot of tips on the use of modifiers and foot care, check it out at Findacode.com. There is also a book I co-authored that may be helpful called "Podiatry Reimbursement Guide" by innoviHealth. Podiatry and foot care are very specific with billing and reimbursement, it would be a helpful resource to have.

https://www.findacode.com/library/innovihealth/rg-po/index.html

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