Trimming of Dystrophic Nails - Non-Medicare Billing

[jdmc1973]

Example: A physician trims fingernails or toenails, usually with scissors, nail cutters, or another instrument when the nails are dystrophic from nutritional or metabolic abnormalities. So in this case, we're only trimming the 3 nails but there doesn't seem to be a good code to use. Would we use 11720 for debridement of 3 nails with a diagnosis code of 250.80 since the patient has DMII with dystrophic nails or would we use the unlisted code to capture the charge?

 

[Porter_kd]

Since the patient has dystrophic nails, I would use ICD-9 code 703.8 as first listed diagnosis code and you stated patient is diabetic? Is the doctor linking the metabolic abnormalities to diabetes? Does it state, Due to, associated with, contributing to, with diabetes? if not, then 250.80 should not be used. 11720 is a valid code for the trimming of dystophic nails and can use diabetes as a secondary diagnosis as well. Another thing, does the patient insurance company cover it? Usually it doesn't because most healthy patients can trim their own nails??