You Be the Coder:
Stick It Out With Primary Diagnosis Code
Published on Sun Jun 20, 2010
Question: I heard that when billing CPT 11721, diagnosis code 110.1 needs to be the primary diagnosis code. When billing CPT 11055, the primary diagnosis code should be 700. Assuming the patient has a systemic diagnosis as well, how do you bill both procedure codes on the same claim for same date of service?New York SubscriberAnswer: Assuming you are billing for outpatient provider services, you should bill them on the same CMS 1500 form but you should change the diagnosis pointers for each claim line. You can list more than one diagnosis code on the form -- just point the diagnosis to the procedure.Here's how you should report it: Box 211. 110.1 (Dermatophytosis of nail)2. 700 (Corns and callosities)3. 443.9 (Peripheral vascular disease, unspecified) CPT diagnosis pointer11721 (Debridement of nails, by any method 6 or more) 1, 311055 (Paring or cutting of benign hyperkeratotic lesion [e.g., corn or callus]; single lesion) [...]