Podiatry Coding & Billing Alert

Question: A patient presents for a follow-up of an ingrown toenail. The physician finds that the patient now has two ingrown toenails -- one on each foot. The physician removes both from each toe and also did a silver nitrate cauterization. Should I report the following codes: 99212, 11750, 11750-50, 17250?Hampshire SubscriberAnswer: Your claim is partially correct. You should report 99212-25 as well as 11750 (Excision of nail and nail matrix, partial or complete [e.g., ingrown or deformed nail] for permanent removal), but not 17250 (Chemical cauterization of granulation tissue [proud flesh, sinus or fistula]).E/M: Because the diagnosis is new to one toe, you could justify 99212 (Office or other outpatient visit for the evaluation and management of an established patient ...). The patient presents for follow-up of one ingrown toenail. The physician, however, has not previously examined the other now ingrown toenail.You should also append modifier 25 (Significant, separately identifiable [...]