I&D and patial toe nail removal of ingowing nail

[riverloverjen38@yahoo.com]

I could use some feedback regarding a scenario.

Physician diagnosis is "Ingrowing toe nail." Procedure is documented as I&D of abscess with partial nail plate removal. Any suggestions on how to code this? Do I code both the I&D and the nail removal?

Thanks.

 

[danskangel313]

If you code for the I&D, you'd likely get a bundling edit for the nail removal. But the fact that the patient has an ingrowing toenail doesn't inherently mean the patient also has an abscess, so it'd be a stretch to meet the medical necessity of the I&D with just that DX. The documentation doesn't explain the abscess at all really. If it were me, I'd get clarification from the provider because the I&D will high a much higher reimbursement if the documentation supports it.