Billing and Coding: Nail Debridement

Coverage for nail debridement under this article is contingent on meeting all indications and limitations of LCD L33922 and applicable CMS medical necessity/payment rules. Documentation must be complete—legible records with patient identifiers, provider signature, supported ICD-10 and CPT/HCPCS coding, documentation of affected nail(s), clinical evidence of mycosis, manner and extent of debridement, antifungal treatment status, and qualifying toenail symptoms; frequency limits are specified in LCD L33922 and utilization must follow locally acceptable standards and may be audited.

"Nail debridement is covered only when the service meets all indications and limitations specified in LCD L33922 and applicable CMS medical necessity and payment rules."

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