If a tourniquet is used, it should be removed as soon Article revised and posted on 12/16/2021 effective for dates of service on and after 01/30/2022.Draft article posted on 07/29/2021. CPT Note. All diagnoses not listed in the ICD-9-CM Codes That Support Medical Necessity section of this LCD. Ordered and furnished by qualified personnel. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). This Agreement will terminate upon notice if you violate its terms. B. Single-center (Refer to LCD: Routine Foot Care). Crushing injuries of the toes. A medically reasonable and necessary repeat avulsion or excision of the same nail within 32 weeks of a previous avulsion, or excision, of the same nail, will be considered upon redetermination. There is no CPT codes covered if selection criteria are met: 11055: Paring or cutting of benign hyperkeratotic lesion (e.g., corn or callus); single lesion: 11056: two to four lesions: The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This condition most commonly occurs in the great toes and may require surgical management. Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). The following surgical procedures represent the options used to treat complicated/symptomatic ingrowing nail(s): Avulsion of a nail (CPT codes 11730 and 11732) involving separation and removal of the entire nail plate or a portion of nail plate (including the entire length of the nail border to and under the eponychium). not endorsed by the AHA or any of its affiliates. National Correct Coding Initiative (NCCI) Citation: Social Security Act (Title XVIII) Standard References: This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L34887 Surgical Treatment of Nails. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT descriptors in policies published on the Web. A Draft article will eventually be replaced by a Billing and Coding article once the Proposed LCD is released to a final LCD. Coding #2. 11730 is more appropriate. 11750 is for permanent removal and your note does not give any indication that this was permanent. Check with the insurance company on whether I&D is also billable. CPT codes, descriptions and other data only are copyright 2022 American Medical Association. For a better experience, please enable JavaScript in your browser before proceeding. Deformed nails that prevent wearing shoes or otherwise jeopardize the integrity of the toe. CPT 11055, 11056, 11057, 11719, 11720, 11721 - Routine A fingertip contusion may result in a subungual hematoma requiring trephination to relieve pressure and pain. THE UNITED STATES Question: Are there different codes for managing nail problems? Routine foot care is covered only when certain systemic conditions are present.

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