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Coding And Billing Pearls

The CPT codes shown in Box 18-3 are used when billing for nail procedures. When treating an ingrown toenail, the partial removal of the nail plate is coded using CPT 11730. If a partial matrixectomy (chemical or physical) is performed as well, a CPT code of 11750 is added. This is not only good medical practice for recurring ingrown toenails but also results in greater compensation.

Box 18-3 

CPT Codes for Nail Procedures

  11719 Trimming of nondystrophic nails, any number
  11720 Debridement of nail(s) by any method(s); 1 to 5 nails
  11721 Debridement of nail(s) by any method(s); 6 or more nails
  11730 Removal (avulsion) of one nail plate, partial or complete, simple; single nail
  11732 Removal (avulsion) of additional nail plates, partial or complete, simple
  11755 Biopsy of nail unit (e.g., plate, bed, matrix, hyponychium, proximal, and lateral nail folds)
  11750 Removal of nail bed or nail matrix, partial or complete (e.g., ingrown or deformed nail), for permanent removal.
  11760 Repair of nail bed
  11765 Wedge excision of skin of nail fold (e.g., for ingrown toenail)
  11740 Subungual hematoma drainage

Debridement of a nail is a procedure that is intended to remove excessive material (e.g., to significantly reduce nail thickness/bulk) or excessive curvature from a clinically and significantly thickened dystrophic or diseased nail. Although podiatrists may be more likely to do this procedure, the code is independent of the clinician performing the procedure.