02/27/2019

Correct Billing for 1st Visit-Avulsion of Ingrown Toenail and 2nd Visit-Nail Debridement of Thick Nail Developing Into Ingrown

I had a patient with ingrown nail present to my office 2/13/19. I avulsed and billed 11730. She returned 2/22/19 for covered nail debridement(thick nail with pain and ingrowing). I would bill 11720,but doesn't this fall in the global period of 11730? Which modifier,if any,is appropriate?

Billing CPT 11720 would be appropriate since the nail that was debrided is a different digit than the one that the nail avulsion was performed on. The procedure code should be billed with Modifier 79 as the primary modifier so separate payment would be made for routine foot care service; no Q modifier is required since the patient meets routine foot care coverage under the mycotic nail rule under the LCD policy.