Wiki 11750 multiple procedure guidelines

[Dnolan313]

Is anyone aware of any guidelines relating to destruction of nail matrix cpt 11750 partial ; lateral or medial performed at two separate visits ? My experience has always been that you can only bill one 11750 per toe. However, the situation we were presented with,not once but twice ,was that we did a partial matrix of the lateral border and then a week later patient presents with medial border ingrown and the doctor performs another 11750 of the same toe. Can this be billed separately if documentation supports a new condition ?

 

[annamaria70]

We do not have any specific policy to bill 11750, and for this procedure apply general rules of surgery. You can bill second 11750, performed later on another date of service, with Mod 79, if it was done during global 10 day, and this procedure unrelated and is not complication of previously done procedure.
So, for example,
04/04/14- 11750-TA
04/11/14- 11750-79,TA.
Definitely, documentation should support all of these procedures.

Hope it helps.
Best wishes.

 

[Dnolan313]

Annamarie1827 ; Thank you for your input. And yes, I actually had to go back to the doctor to ask for better documentation to support his decision making. That is always a must.

 

[johnsom]

If they do a fibular and tibial border on the same toe on the same visit. Do I bill the 11750 once or twice since we did two borders?

 

[deannewoods17]

If they do a fibular and tibial border on the same toe on the same visit. Do I bill the 11750 once or twice since we did two borders?

CURIOUS IF YOU EVER FOUND AN ANSWER ON THIS?

 

[podcoder70]

CURIOUS IF YOU EVER FOUND AN ANSWER ON THIS?

Matrixectomy 11750 bilateral borders, medial and lateral, SAME toe, bill once per toe.

 

[amyjph]

Matrixectomy 11750 bilateral borders, medial and lateral, SAME toe, bill once per toe.

Agree