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Cutting toenails

  1. #1
    Default Cutting toenails
    Medical Coding Books
    As a family practice can we bill for clipping toenails? And what CPT would you use? I searched this on the Medicare website and I can't find a payable CPT. Thanks for your help!

  2. #2
    North Carolina
    Quote Originally Posted by nneecole View Post
    As a family practice can we bill for clipping toenails? And what CPT would you use? I searched this on the Medicare website and I can't find a payable CPT. Thanks for your help!
    2. Routine Foot Care

    Except as provided above, routine foot care is excluded from coverage. Services that normally are considered routine and not covered by Medicare include the following:

    • The cutting or removal of corns and calluses;
    The trimming, cutting, clipping, or debriding of nails; and
    • Other hygienic and preventive maintenance care, such as cleaning and soaking the feet, the use of skin creams to maintain skin tone of either ambulatory or bedfast patients, and any other service performed in the absence of localized illness, injury, or symptoms involving the foot.

    Page 259

  3. #3
    Thank you so much. I am going to print the page and show my office manager. I was told before that toe nail trimming is cover by Medicare if the pt is morbidly obese, diabetic or has onchomycosis. Thank you again for your help!

  4. #4
    North Carolina
    You're welcome...

    Be sure to read the guidelines that may allow coverage if the requirements are met.

    "The presence of a systemic condition such as metabolic, neurologic, or peripheral vascular disease may require scrupulous foot care by a professional that in the absence of such condition(s) would be considered routine (and, therefore, excluded from coverage). Accordingly, foot care that would otherwise be considered routine may be covered when systemic condition(s) result in severe circulatory embarrassment or areas of diminished sensation in the individual's legs or feet. (See subsection A.)

    In these instances, certain foot care procedures that otherwise are considered routine (e.g., cutting or removing corns and calluses, or trimming, cutting, clipping, or debriding nails) may pose a hazard when performed by a nonprofessional person on patients with such systemic conditions. (See §290.G for procedural instructions.)"

  5. #5
    and make sure the notes identify which ones.
    "Clipped 6 nails" is not enough documentation.

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