03/20/2020

Correct Coding for Left Hallux Nail Avulsion-Lacerated Nail Cauterized with 2 Applications of AgNo3

I removed a toenail today on a patient. This was a total nail avulsion left hallux. Upon removal of the nail, I noticed her nail bed was lacerated and I cauterized this with 2 application AgNo3.DX: L60.0 and L03.032 .Is there a code for lacerated nail bed?

There is a code for a lacerated nail bed repair- the correct CPT code to bill is 11760 (repair of nail bed). The diagnosis codes reported for the nail avulsion are appropriate to bill for this more complex procedure, along with an injury code that describes the laceration. Note that if a nail bed repair is performed, the avulsion of the nail plate is not a separately reimbursed service and is inclusive to the payment of the nail bed repair.

11760

Repair of nail bed

Lay Description (Code):

The physician repairs a damaged nail bed. The physician removes the damaged and surrounding nail from the nail bed. The nail bed is sutured into correct position. Bleeding is controlled through electrocautery and the wound is dressed.

Coding Tips   

For reconstruction of a nail bed, see 11762. Local anesthesia is included in this procedure. Some payers may require the use of HCPCS Level II modifiers FA–F9 or TA–T9 to identify the specific finger or toe involved. It is inappropriate to report supplies when these services are performed in an emergency room. For physician offices, supplies may be reported with the appropriate HCPCS Level II code. Check with the specific payer to determine coverage.