I wish there was a code for nails that just need to be trimmed, but the only codes I have been able to find are the ones for the Mycotic nail. Medicare and most private payers do not consider trimming nails to be medically necessary unless the patient has disease of the nail, such as onychomysis, and a systemic condition such as diabetes. Then if they meet this criteria we also have to have the Name, NPI number and the last date they saw their primary care physician.
As you can see trimming the toenails is difficult if not impossible to get paid for. Unless you have the ability to get the patient to sign the ABN prior to the service being don.
Evelyn Kim, MA, CPC
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