09/27/2022

Correct Billing for CPT 10060 and 11721

What is the correct way to bill CPT Code 10060 and CPT code 11721? MVP originally paid for the 10060 but denied 11721 stating not bundled.

When billing MVP Healthcare for the I&D and nail debridement, there should be use of modifier -59, only on the nail procedure. If MVP denied the charge, it should be appealed with progress notes demonstrating why the routine foot care should be unbundled from the minor procedure. The notes should be submitted along with the claim adjustment request form (see link below). Once submitted, the insurance should issue an updated EOB with the results of the review.

Claim Adjustment Request Form (mvphealthcare.com)