Billing and Coding: Surgical Treatment of Nails

Coverage for surgical treatment of nails follows LCD L33833 and is allowed when reasonable and necessary. CPT 11730/11732 cover partial or complete nail avulsions, CPT 11750 covers permanent nail excision with matrix destruction, and CPT 11765 covers wedge excision of the nail fold; coding and unit rules apply per nail and per date of service. Repeat procedures are restricted by timeframes (11730/11732: >=16 weeks for fingers, >=32 weeks for toes; 11750: generally not repeatable) unless KX is appended with specific supporting documentation, and detailed, legible medical record documentation is required for payment.

"Services are covered when they meet the reasonable and necessary requirements of LCD L33833 for surgical treatment of nails."

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