12/21/2020

Correct Billing for CPT Codes 11750, L03031, L03032, 99203

What would be the appropriate way to bill multiple CPT codes 11750. L03031 L03032 99203 11750(Left)TA, T4, 11750(Right)T5, T7, T8, T9

For each matrixectomy, every digit should be billed on a separate line item. There should be a total of six line items on the claim, each line with a corresponding-T modifier to indicate what toenail the minor surgery was performed on. Modifier -59 should not be used on any of the line items since the -T modifiers give enough information that each procedure was performed on a separate digit. Only one diagnosis code should be linked per line item. For the line items of -TA & -T4, it should be billed with ICD-10 code L03.032. For the digits on the right foot, they should be billed with an ICD-10 of L03.031. Given the number of nails that were removed, documentation should be readily available to justify the number of procedures performed and the medical necessity.