03/23/2017

Proper Billing for CPT Code 11750 & CPT Code Replacements for 11752

CPT Code 11750 was performed 4x- 2x Left & 2x Right on each side of the BIG TOE-- TA mod-lt T5 mod- rt how would this be billed since we cant use the cpt code 11752 anymore.

The correct way to bill for the above mentioned is: 11750 TA and 11750 T5.  

Definition:

11750: Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal;

Lay Description:

The physician removes all or part of a fingernail or toenail, including the nail plate and matrix permanently. The nail plate is bluntly dissected and lifted away from the nail bed. The nail plate is detached from the matrix using a scalpel. The matrix is destroyed using chemical ablation, CO2 laser, or electrocautery. The wound is dressed loosely.

Coding Tip:

Note that 11750 may be reported only once per digit. A partial excision of the nail does not count as two separate procedures, even when the partial excision requires two incisions (medial and lateral aspects). 

As for CPT Code 11752 (Deleted as of January 2017), the two codes below may be used as replacements:

• 28124 (Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe)
• 28160 (Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each)