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Podiatry Coding & Billing Alert

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Biopsy vs. Debridement: A Cutting Question

Published on Tue Jan 20, 2009

Question: Our podiatrist cuts nails and sends them out to the laboratory for a potassium hydroxide (KOH) study. Should I report the procedure as a biopsy or as a debridement? New York Subscriber Answer: You'll determine whether you should use a biopsy or debridement code by determining how much of the nail and/or tissue your podiatrist removes and sends for testing determines. Option 1: You should use 11755 (Biopsy of nail unit [eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds] [separate procedure]) only if your podiatrist sends the nail unit, including folds, bed, and/or matrix, along with a section of the hard nail. Tip: While a nail biopsy is a separate procedure, podiatrists usually perform the biopsy as part of a more complex service. If the physician performs a biopsy only, you can report 11755 on its own. If the podiatrist performs the biopsy along with an unrelated [...]
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