Billing and Coding: Surgical Treatment of Nails

This billing/coding guideline defines correct use of CPT codes for surgical treatment of nails: CPT 11730/11732/11750 cover all services on a single nail for that date of service and should not be split by nail border. Certain code combinations for the same digit on the same date (e.g., avulsion with excision or wedge resection) and using 11765 without local anesthesia are not correct; repeat avulsions require specific medical-necessity documentation if performed sooner than 16 weeks (finger) or 32 weeks (toe). When procedures are performed on different nails, report each with one unit of service and append appropriate digit modifiers, and use CPT 11732 as the add-on code for subsequent avulsions.

"Repeat partial or complete nail avulsion (CPT 11730 or 11732) on the same finger or toe is covered when medically reasonable and necessary and the medical record documents a specific indication (e."