02/20/2019

Correct Billing for Ingrown Nail Distal Left Hallux with Mild Pyogenic Granuloma-Debridement and Cauterization

I saw a patient with a ingrown nail distal left hallux with mild pyogenic granuloma.I debrided both and cauterized the pyogenic granuloma but did not avulse the nail.How is it billed?

Since subcutaneous tissue was debrided as a way to treat the pyogenic granuloma, the following procedure code should be billed:

11042 (Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less)

There should be two diagnosis codes billed with the procedure, no modifiers required:

• L98.0 (Pyogenic granuloma)
• L60.0 (Ingrowing nail)

The cauterization of the site where the granuloma was is bundled in the debridement procedure and does not have a separate CPT code- this component of the service would be considered inclusive to CPT 11042.