• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

debridement of nail

espressoguy

Expert
Messages
406
Location
Tacoma, WA
Best answers
0
Nail debridement is considered routine foot care, which is a non-covered service.

Medicare will cover nail debridement if certain conditions exist. What was the diagnosis?
 

bbenton03

Guest
Messages
8
Best answers
0
It was a fingernail for ingrowing. Is it because it needs a modifier showing which finger?
 

espressoguy

Expert
Messages
406
Location
Tacoma, WA
Best answers
0
Sorry, since I code podiatry I just assumed it was a toenail :eek:

11720 is for 1-5 nails so they aren't looking for a finger modifier.

What's the reason for the denial? What is the medical necessity?

Edited to add: The CPT doesn't distinguish between fingernails and toenails, so Medicare wouldn't specifically know this was a fingernail. I wonder if the same guidelines apply?
 
Last edited:
Top