11/13/2018

Proper Coding for Nail Avulsion & Punch Biopsy on the Nail Matrix-LT 2nd Digit for Melanonychia

I performed a nail avulsion and a punch biopsy on the nail matrix on the left 2nd digit for melanoynchia L60.8 are the following CPT and modifiers correct? 11730 51 T1 11100 59 T1

The CPT code billed for the nail avulsion is correct. The charge should only be submitted with the T1 modifier to indicate which nail plate was avulsed during the encounter. Modifier 51 is not required for the initial procedure performed on a patient.

For the punch biopsy of the nail bed, the CPT code billed is correct. The procedure code should only be appended with modifier 59 to show that this is a distinct procedure that should be reimbursed separately to the nail avulsion. T modifiers are not appropriate for this type of surgical procedure and should not be added for this service.