Billing and Coding: Routine Foot Care and Debridement of Nails

Medicare Part B covers routine foot care and debridement of nails when provided in specified places of service and when documentation meets LCD L34246 medical necessity requirements. Debridement of mycotic nails or treatment for onychogryphosis/onychauxis requires a primary diagnosis of the nail condition plus a secondary diagnosis indicating a systemic condition, secondary infection, or pain (see LCD ICD-10 list); specific coding, ABN modifier rules, and detailed clinical documentation (including per-nail descriptions for mycotic debridement) are required. Certain CPT/HCPCS codes (11719, 11720, 11721, G0127) must be billed with unit=1 and shaving versus parring code sets must be used according to lesion type.

"Routine foot care and debridement of nails are payable under Medicare Part B when performed in approved places of service (POS 11,12,13,14,19,20[11720/11721 only],21,22,24,31,32,33,49,51,52,53,54,5..."