LCD Reference Article Billing and Coding Article

Billing and Coding: Surgical Treatment of Nails

A52998

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Contractor Information

Contractor Name	Contract Type	Contract Number	Jurisdiction	States
Novitas Solutions, Inc.	A and B MAC	04111 - MAC A	J - H	Colorado
Novitas Solutions, Inc.	A and B MAC	04112 - MAC B	J - H	Colorado
Novitas Solutions, Inc.	A and B MAC	04211 - MAC A	J - H	New Mexico
Novitas Solutions, Inc.	A and B MAC	04212 - MAC B	J - H	New Mexico
Novitas Solutions, Inc.	A and B MAC	04311 - MAC A	J - H	Oklahoma
Novitas Solutions, Inc.	A and B MAC	04312 - MAC B	J - H	Oklahoma
Novitas Solutions, Inc.	A and B MAC	04411 - MAC A	J - H	Texas
Novitas Solutions, Inc.	A and B MAC	04412 - MAC B	J - H	Texas
Novitas Solutions, Inc.	A and B MAC	04911 - MAC A	J - H	Colorado New Mexico Oklahoma Texas
Novitas Solutions, Inc.	A and B MAC	07101 - MAC A	J - H	Arkansas
Novitas Solutions, Inc.	A and B MAC	07102 - MAC B	J - H	Arkansas
Novitas Solutions, Inc.	A and B MAC	07201 - MAC A	J - H	Louisiana
Novitas Solutions, Inc.	A and B MAC	07202 - MAC B	J - H	Louisiana
Novitas Solutions, Inc.	A and B MAC	07301 - MAC A	J - H	Mississippi
Novitas Solutions, Inc.	A and B MAC	07302 - MAC B	J - H	Mississippi
Novitas Solutions, Inc.	A and B MAC	12101 - MAC A	J - L	Delaware
Novitas Solutions, Inc.	A and B MAC	12102 - MAC B	J - L	Delaware
Novitas Solutions, Inc.	A and B MAC	12201 - MAC A	J - L	District of Columbia
Novitas Solutions, Inc.	A and B MAC	12202 - MAC B	J - L	District of Columbia
Novitas Solutions, Inc.	A and B MAC	12301 - MAC A	J - L	Maryland
Novitas Solutions, Inc.	A and B MAC	12302 - MAC B	J - L	Maryland
Novitas Solutions, Inc.	A and B MAC	12401 - MAC A	J - L	New Jersey
Novitas Solutions, Inc.	A and B MAC	12402 - MAC B	J - L	New Jersey
Novitas Solutions, Inc.	A and B MAC	12501 - MAC A	J - L	Pennsylvania
Novitas Solutions, Inc.	A and B MAC	12502 - MAC B	J - L	Pennsylvania
Novitas Solutions, Inc.	A and B MAC	12901 - MAC A	J - L	Delaware District of Columbia Maryland New Jersey Pennsylvania

Article Information

General Information

Article ID
A52998

Article Title
Billing and Coding: Surgical Treatment of Nails

Article Type
Billing and Coding

Original Effective Date
10/01/2015

Revision Effective Date
10/19/2023

Revision Ending Date
N/A

Retirement Date
N/A

AMA CPT / ADA CDT / AHA NUBC Copyright Statement

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Copyright © 2023, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Internet-Only Manuals (IOMs):

CMS IOM Publication 100-04, Medicare Claims Processing Manual,
- Chapter 23, Section 20.9 National Correct Coding Initiative (NCCI)

National Correct Coding Initiative (NCCI) Citation:

Medicare NCCI Policy Manual,
- Chapter 1, General Correct Coding Policies for Medicare National Correct Coding Initiative Policy Manual
- Chapter 3, Surgery: Integumentary System CPT codes 10000-19999 for Medicare National Correct Coding Initiative Policy Manual

Social Security Act (Title XVIII) Standard References:

Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L34887 Surgical Treatment of Nails. Please refer to the LCD for reasonable and necessary requirements.

Coding Guidance

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

The description of CPT codes 11730, 11732 and 11750 indicates partial or complete avulsion or excision of a nail plate. When CPT code 11730, 11732 or 11750 is reported, it represents all services performed on that nail for that date of service (DOS). When lateral and medial sides of a nail are involved, do not report a separate code for each border.

Procedure code 11750 (Excision of nail and nail matrix, partial or complete, [e.g., ingrown or deformed nail] for permanent removal) requires the removal of the full length or the entire nail plate, with destruction or permanent removal of the matrix by any means.

Reporting CPT codes 11730 or 11732 (removal of nail plate) with CPT code 11750 (removal of nail bed) and or 11765 (excision of nail fold toe) for the same digit on the same DOS is not correct coding.

Reporting CPT code 11750 (removal of nail bed) with CPT code 11765 (excision of nail fold toe) for the same digit on the same DOS is not correct coding.

CPT code 11765 requires an excision of a wedge of the skin of the nail fold from the involved side of the toe. Reporting CPT code 11765 for the removal of a small piece of the skin and/or the nail without local anesthesia is not correct coding.

Procedure code 11730 (Avulsion of nail plate, partial or complete, simple; single) is reported when removing part of the nail plate or the entire nail plate.

Claims must include the nail on which the procedure is performed using one of the modifiers listed in the Coding Information section below to identify the digit in order for payment to be considered.

For services performed on different nails:

If CPT procedure codes 11730, 11750, or 11765 are performed on different nails, report the procedure performed with one unit of service (UOS) and append with the appropriate identifying digit modifiers.
For every subsequent avulsion, CPT 11732 is reported as the add-on code with one UOS and the appropriate identifying digit modifier appended.

Utilization Parameters

CPT codes 11730 and 11732 for nail avulsion will be denied if billed for the same finger less than 4 months (16 weeks) or the same toe less than 8 months (32 weeks) following a previous avulsion.

A medically reasonable and necessary repeat avulsion of the same nail within 16 weeks (finger) or 32 weeks (toe) of a previous avulsion of the same nail, will be considered upon redetermination. The medical record must support the service, for example, there is an ingrown nail of the opposite border or a new significant pathology on the same border recently treated.

CPT code 11750 for nail excision permanent removal will be denied if billed for the same finger or toe following a previous excision.

For a medically reasonable and necessary repeat nail excision on the same finger or toe, report modifier KX (Requirements specified in the medical record have been met). The medical record documentation must be specific as to the indication, such as ingrown nail of the opposite border or new significant pathology on the same border previously treated.

Documentation Requirements

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.
The following information must be clearly documented in the patient’s medical record:

- Complete detailed description of the pre-operative findings. Include the patient’s symptoms, the physical examination documenting the severity of the nail infection, injury or deformity, and the assessment and plan containing the rationale why surgical treatment is being selected over other treatment options.
- Method of obtaining anesthesia (if not used, the reason for not using it).
- A complete detailed description of the procedure performed.
- Identify the specific digit(s) and make note to the nail margin(s) involved on which the procedure was performed.
- Postoperative observation and treatment of the surgical site (e.g., minimal bleeding, sterile dressing applied).
- Postoperative instructions given to the patient and any follow-up care (e.g., soaks, antibiotics, follow-up appointments).

Response To Comments

Number	Comment	Response
1

Coding Information

Bill Type Codes

Code	Description
999x	Not Applicable

Revenue Codes

Code	Description
99999	Not Applicable

CPT/HCPCS Codes

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Group 1

(4 Codes)

Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.

Group 1 Codes

Code	Description
11730	Removal of nail plate
11732	Remove nail plate add-on
11750	Removal of nail bed
11765	Excision of nail fold toe

CPT/HCPCS Modifiers

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Group 1

(20 Codes)

Group 1 Paragraph

N/A

Group 1 Codes

Code	Description
F1	LEFT HAND, SECOND DIGIT
F2	LEFT HAND, THIRD DIGIT
F3	LEFT HAND, FOURTH DIGIT
F4	LEFT HAND, FIFTH DIGIT
F5	RIGHT HAND, THUMB
F6	RIGHT HAND, SECOND DIGIT
F7	RIGHT HAND, THIRD DIGIT
F8	RIGHT HAND, FOURTH DIGIT
F9	RIGHT HAND, FIFTH DIGIT
FA	LEFT HAND, THUMB
T1	LEFT FOOT, SECOND DIGIT
T2	LEFT FOOT, THIRD DIGIT
T3	LEFT FOOT, FOURTH DIGIT
T4	LEFT FOOT, FIFTH DIGIT
T5	RIGHT FOOT, GREAT TOE
T6	RIGHT FOOT, SECOND DIGIT
T7	RIGHT FOOT, THIRD DIGIT
T8	RIGHT FOOT, FOURTH DIGIT
T9	RIGHT FOOT, FIFTH DIGIT
TA	LEFT FOOT, GREAT TOE

ICD-10-CM Codes that Support Medical Necessity

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Group 1

(392 Codes)

Group 1 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 11730, 11732, 11750, and 11765.

Group 1 Codes

Code	Description
B35.1	Tinea unguium
I96	Gangrene, not elsewhere classified
L03.011	Cellulitis of right finger
L03.012	Cellulitis of left finger
L03.031	Cellulitis of right toe
L03.032	Cellulitis of left toe
L40.0	Psoriasis vulgaris
L40.1	Generalized pustular psoriasis
L40.2	Acrodermatitis continua
L40.3	Pustulosis palmaris et plantaris
L40.4	Guttate psoriasis
L40.8	Other psoriasis
L43.0	Hypertrophic lichen planus
L43.3	Subacute (active) lichen planus
L43.8	Other lichen planus
L60.0	Ingrowing nail
L60.1	Onycholysis
L60.2	Onychogryphosis
L60.3	Nail dystrophy
L60.4	Beau's lines
L60.5	Yellow nail syndrome
L60.8*	Other nail disorders
Q84.3	Anonychia
Q84.4	Congenital leukonychia
Q84.5	Enlarged and hypertrophic nails
Q84.6	Other congenital malformations of nails
S60.111A	Contusion of right thumb with damage to nail, initial encounter
S60.111D	Contusion of right thumb with damage to nail, subsequent encounter
S60.111S	Contusion of right thumb with damage to nail, sequela
S60.112A	Contusion of left thumb with damage to nail, initial encounter
S60.112D	Contusion of left thumb with damage to nail, subsequent encounter
S60.112S	Contusion of left thumb with damage to nail, sequela
S60.121A	Contusion of right index finger with damage to nail, initial encounter
S60.121D	Contusion of right index finger with damage to nail, subsequent encounter
S60.121S	Contusion of right index finger with damage to nail, sequela
S60.122A	Contusion of left index finger with damage to nail, initial encounter
S60.122D	Contusion of left index finger with damage to nail, subsequent encounter
S60.122S	Contusion of left index finger with damage to nail, sequela
S60.131A	Contusion of right middle finger with damage to nail, initial encounter
S60.131D	Contusion of right middle finger with damage to nail, subsequent encounter
S60.131S	Contusion of right middle finger with damage to nail, sequela
S60.132A	Contusion of left middle finger with damage to nail, initial encounter
S60.132D	Contusion of left middle finger with damage to nail, subsequent encounter
S60.132S	Contusion of left middle finger with damage to nail, sequela
S60.141A	Contusion of right ring finger with damage to nail, initial encounter
S60.141D	Contusion of right ring finger with damage to nail, subsequent encounter
S60.141S	Contusion of right ring finger with damage to nail, sequela
S60.142A	Contusion of left ring finger with damage to nail, initial encounter
S60.142D	Contusion of left ring finger with damage to nail, subsequent encounter
S60.142S	Contusion of left ring finger with damage to nail, sequela
S60.151A	Contusion of right little finger with damage to nail, initial encounter
S60.151D	Contusion of right little finger with damage to nail, subsequent encounter
S60.151S	Contusion of right little finger with damage to nail, sequela
S60.152A	Contusion of left little finger with damage to nail, initial encounter
S60.152D	Contusion of left little finger with damage to nail, subsequent encounter
S60.152S	Contusion of left little finger with damage to nail, sequela
S61.111A	Laceration without foreign body of right thumb with damage to nail, initial encounter
S61.111D	Laceration without foreign body of right thumb with damage to nail, subsequent encounter
S61.111S	Laceration without foreign body of right thumb with damage to nail, sequela
S61.112A	Laceration without foreign body of left thumb with damage to nail, initial encounter
S61.112D	Laceration without foreign body of left thumb with damage to nail, subsequent encounter
S61.112S	Laceration without foreign body of left thumb with damage to nail, sequela
S61.121A	Laceration with foreign body of right thumb with damage to nail, initial encounter
S61.121D	Laceration with foreign body of right thumb with damage to nail, subsequent encounter
S61.121S	Laceration with foreign body of right thumb with damage to nail, sequela
S61.122A	Laceration with foreign body of left thumb with damage to nail, initial encounter
S61.122D	Laceration with foreign body of left thumb with damage to nail, subsequent encounter
S61.122S	Laceration with foreign body of left thumb with damage to nail, sequela
S61.131A	Puncture wound without foreign body of right thumb with damage to nail, initial encounter
S61.131D	Puncture wound without foreign body of right thumb with damage to nail, subsequent encounter
S61.131S	Puncture wound without foreign body of right thumb with damage to nail, sequela
S61.132A	Puncture wound without foreign body of left thumb with damage to nail, initial encounter
S61.132D	Puncture wound without foreign body of left thumb with damage to nail, subsequent encounter
S61.132S	Puncture wound without foreign body of left thumb with damage to nail, sequela
S61.141A	Puncture wound with foreign body of right thumb with damage to nail, initial encounter
S61.141D	Puncture wound with foreign body of right thumb with damage to nail, subsequent encounter
S61.141S	Puncture wound with foreign body of right thumb with damage to nail, sequela
S61.142A	Puncture wound with foreign body of left thumb with damage to nail, initial encounter
S61.142D	Puncture wound with foreign body of left thumb with damage to nail, subsequent encounter
S61.142S	Puncture wound with foreign body of left thumb with damage to nail, sequela
S61.151A	Open bite of right thumb with damage to nail, initial encounter
S61.151D	Open bite of right thumb with damage to nail, subsequent encounter
S61.151S	Open bite of right thumb with damage to nail, sequela
S61.152A	Open bite of left thumb with damage to nail, initial encounter
S61.152D	Open bite of left thumb with damage to nail, subsequent encounter
S61.152S	Open bite of left thumb with damage to nail, sequela
S61.310A	Laceration without foreign body of right index finger with damage to nail, initial encounter
S61.310D	Laceration without foreign body of right index finger with damage to nail, subsequent encounter
S61.310S	Laceration without foreign body of right index finger with damage to nail, sequela
S61.311A	Laceration without foreign body of left index finger with damage to nail, initial encounter
S61.311D	Laceration without foreign body of left index finger with damage to nail, subsequent encounter
S61.311S	Laceration without foreign body of left index finger with damage to nail, sequela
S61.312A	Laceration without foreign body of right middle finger with damage to nail, initial encounter
S61.312D	Laceration without foreign body of right middle finger with damage to nail, subsequent encounter
S61.312S	Laceration without foreign body of right middle finger with damage to nail, sequela
S61.313A	Laceration without foreign body of left middle finger with damage to nail, initial encounter
S61.313D	Laceration without foreign body of left middle finger with damage to nail, subsequent encounter
S61.313S	Laceration without foreign body of left middle finger with damage to nail, sequela
S61.314A	Laceration without foreign body of right ring finger with damage to nail, initial encounter
S61.314D	Laceration without foreign body of right ring finger with damage to nail, subsequent encounter
S61.314S	Laceration without foreign body of right ring finger with damage to nail, sequela
S61.315A	Laceration without foreign body of left ring finger with damage to nail, initial encounter
S61.315D	Laceration without foreign body of left ring finger with damage to nail, subsequent encounter
S61.315S	Laceration without foreign body of left ring finger with damage to nail, sequela
S61.316A	Laceration without foreign body of right little finger with damage to nail, initial encounter
S61.316D	Laceration without foreign body of right little finger with damage to nail, subsequent encounter
S61.316S	Laceration without foreign body of right little finger with damage to nail, sequela
S61.317A	Laceration without foreign body of left little finger with damage to nail, initial encounter
S61.317D	Laceration without foreign body of left little finger with damage to nail, subsequent encounter
S61.317S	Laceration without foreign body of left little finger with damage to nail, sequela
S61.320A	Laceration with foreign body of right index finger with damage to nail, initial encounter
S61.320D	Laceration with foreign body of right index finger with damage to nail, subsequent encounter
S61.320S	Laceration with foreign body of right index finger with damage to nail, sequela
S61.321A	Laceration with foreign body of left index finger with damage to nail, initial encounter
S61.321D	Laceration with foreign body of left index finger with damage to nail, subsequent encounter
S61.321S	Laceration with foreign body of left index finger with damage to nail, sequela
S61.322A	Laceration with foreign body of right middle finger with damage to nail, initial encounter
S61.322D	Laceration with foreign body of right middle finger with damage to nail, subsequent encounter
S61.322S	Laceration with foreign body of right middle finger with damage to nail, sequela
S61.323A	Laceration with foreign body of left middle finger with damage to nail, initial encounter
S61.323D	Laceration with foreign body of left middle finger with damage to nail, subsequent encounter
S61.323S	Laceration with foreign body of left middle finger with damage to nail, sequela
S61.324A	Laceration with foreign body of right ring finger with damage to nail, initial encounter
S61.324D	Laceration with foreign body of right ring finger with damage to nail, subsequent encounter
S61.324S	Laceration with foreign body of right ring finger with damage to nail, sequela
S61.325A	Laceration with foreign body of left ring finger with damage to nail, initial encounter
S61.325D	Laceration with foreign body of left ring finger with damage to nail, subsequent encounter
S61.325S	Laceration with foreign body of left ring finger with damage to nail, sequela
S61.326A	Laceration with foreign body of right little finger with damage to nail, initial encounter
S61.326D	Laceration with foreign body of right little finger with damage to nail, subsequent encounter
S61.326S	Laceration with foreign body of right little finger with damage to nail, sequela
S61.327A	Laceration with foreign body of left little finger with damage to nail, initial encounter
S61.327D	Laceration with foreign body of left little finger with damage to nail, subsequent encounter
S61.327S	Laceration with foreign body of left little finger with damage to nail, sequela
S61.330A	Puncture wound without foreign body of right index finger with damage to nail, initial encounter
S61.330D	Puncture wound without foreign body of right index finger with damage to nail, subsequent encounter
S61.330S	Puncture wound without foreign body of right index finger with damage to nail, sequela
S61.331A	Puncture wound without foreign body of left index finger with damage to nail, initial encounter
S61.331D	Puncture wound without foreign body of left index finger with damage to nail, subsequent encounter
S61.331S	Puncture wound without foreign body of left index finger with damage to nail, sequela
S61.332A	Puncture wound without foreign body of right middle finger with damage to nail, initial encounter
S61.332D	Puncture wound without foreign body of right middle finger with damage to nail, subsequent encounter
S61.332S	Puncture wound without foreign body of right middle finger with damage to nail, sequela
S61.333A	Puncture wound without foreign body of left middle finger with damage to nail, initial encounter
S61.333D	Puncture wound without foreign body of left middle finger with damage to nail, subsequent encounter
S61.333S	Puncture wound without foreign body of left middle finger with damage to nail, sequela
S61.334A	Puncture wound without foreign body of right ring finger with damage to nail, initial encounter
S61.334D	Puncture wound without foreign body of right ring finger with damage to nail, subsequent encounter
S61.334S	Puncture wound without foreign body of right ring finger with damage to nail, sequela
S61.335A	Puncture wound without foreign body of left ring finger with damage to nail, initial encounter
S61.335D	Puncture wound without foreign body of left ring finger with damage to nail, subsequent encounter
S61.335S	Puncture wound without foreign body of left ring finger with damage to nail, sequela
S61.336A	Puncture wound without foreign body of right little finger with damage to nail, initial encounter
S61.336D	Puncture wound without foreign body of right little finger with damage to nail, subsequent encounter
S61.336S	Puncture wound without foreign body of right little finger with damage to nail, sequela
S61.337A	Puncture wound without foreign body of left little finger with damage to nail, initial encounter
S61.337D	Puncture wound without foreign body of left little finger with damage to nail, subsequent encounter
S61.337S	Puncture wound without foreign body of left little finger with damage to nail, sequela
S61.340A	Puncture wound with foreign body of right index finger with damage to nail, initial encounter
S61.340D	Puncture wound with foreign body of right index finger with damage to nail, subsequent encounter
S61.340S	Puncture wound with foreign body of right index finger with damage to nail, sequela
S61.341A	Puncture wound with foreign body of left index finger with damage to nail, initial encounter
S61.341D	Puncture wound with foreign body of left index finger with damage to nail, subsequent encounter
S61.341S	Puncture wound with foreign body of left index finger with damage to nail, sequela
S61.342A	Puncture wound with foreign body of right middle finger with damage to nail, initial encounter
S61.342D	Puncture wound with foreign body of right middle finger with damage to nail, subsequent encounter
S61.342S	Puncture wound with foreign body of right middle finger with damage to nail, sequela
S61.343A	Puncture wound with foreign body of left middle finger with damage to nail, initial encounter
S61.343D	Puncture wound with foreign body of left middle finger with damage to nail, subsequent encounter
S61.343S	Puncture wound with foreign body of left middle finger with damage to nail, sequela
S61.344A	Puncture wound with foreign body of right ring finger with damage to nail, initial encounter
S61.344D	Puncture wound with foreign body of right ring finger with damage to nail, subsequent encounter
S61.344S	Puncture wound with foreign body of right ring finger with damage to nail, sequela
S61.345A	Puncture wound with foreign body of left ring finger with damage to nail, initial encounter
S61.345D	Puncture wound with foreign body of left ring finger with damage to nail, subsequent encounter
S61.345S	Puncture wound with foreign body of left ring finger with damage to nail, sequela
S61.346A	Puncture wound with foreign body of right little finger with damage to nail, initial encounter
S61.346D	Puncture wound with foreign body of right little finger with damage to nail, subsequent encounter
S61.346S	Puncture wound with foreign body of right little finger with damage to nail, sequela
S61.347A	Puncture wound with foreign body of left little finger with damage to nail, initial encounter
S61.347D	Puncture wound with foreign body of left little finger with damage to nail, subsequent encounter
S61.347S	Puncture wound with foreign body of left little finger with damage to nail, sequela
S61.350A	Open bite of right index finger with damage to nail, initial encounter
S61.350D	Open bite of right index finger with damage to nail, subsequent encounter
S61.350S	Open bite of right index finger with damage to nail, sequela
S61.351A	Open bite of left index finger with damage to nail, initial encounter
S61.351D	Open bite of left index finger with damage to nail, subsequent encounter
S61.351S	Open bite of left index finger with damage to nail, sequela
S61.352A	Open bite of right middle finger with damage to nail, initial encounter
S61.352D	Open bite of right middle finger with damage to nail, subsequent encounter
S61.352S	Open bite of right middle finger with damage to nail, sequela
S61.353A	Open bite of left middle finger with damage to nail, initial encounter
S61.353D	Open bite of left middle finger with damage to nail, subsequent encounter
S61.353S	Open bite of left middle finger with damage to nail, sequela
S61.354A	Open bite of right ring finger with damage to nail, initial encounter
S61.354D	Open bite of right ring finger with damage to nail, subsequent encounter
S61.354S	Open bite of right ring finger with damage to nail, sequela
S61.355A	Open bite of left ring finger with damage to nail, initial encounter
S61.355D	Open bite of left ring finger with damage to nail, subsequent encounter
S61.355S	Open bite of left ring finger with damage to nail, sequela
S61.356A	Open bite of right little finger with damage to nail, initial encounter
S61.356D	Open bite of right little finger with damage to nail, subsequent encounter
S61.356S	Open bite of right little finger with damage to nail, sequela
S61.357A	Open bite of left little finger with damage to nail, initial encounter
S61.357D	Open bite of left little finger with damage to nail, subsequent encounter
S61.357S	Open bite of left little finger with damage to nail, sequela
S67.01XA	Crushing injury of right thumb, initial encounter
S67.01XD	Crushing injury of right thumb, subsequent encounter
S67.01XS	Crushing injury of right thumb, sequela
S67.02XA	Crushing injury of left thumb, initial encounter
S67.02XD	Crushing injury of left thumb, subsequent encounter
S67.02XS	Crushing injury of left thumb, sequela
S67.190A	Crushing injury of right index finger, initial encounter
S67.190D	Crushing injury of right index finger, subsequent encounter
S67.190S	Crushing injury of right index finger, sequela
S67.191A	Crushing injury of left index finger, initial encounter
S67.191D	Crushing injury of left index finger, subsequent encounter
S67.191S	Crushing injury of left index finger, sequela
S67.192A	Crushing injury of right middle finger, initial encounter
S67.192D	Crushing injury of right middle finger, subsequent encounter
S67.192S	Crushing injury of right middle finger, sequela
S67.193A	Crushing injury of left middle finger, initial encounter
S67.193D	Crushing injury of left middle finger, subsequent encounter
S67.193S	Crushing injury of left middle finger, sequela
S67.194A	Crushing injury of right ring finger, initial encounter
S67.194D	Crushing injury of right ring finger, subsequent encounter
S67.194S	Crushing injury of right ring finger, sequela
S67.195A	Crushing injury of left ring finger, initial encounter
S67.195D	Crushing injury of left ring finger, subsequent encounter
S67.195S	Crushing injury of left ring finger, sequela
S67.196A	Crushing injury of right little finger, initial encounter
S67.196D	Crushing injury of right little finger, subsequent encounter
S67.196S	Crushing injury of right little finger, sequela
S67.197A	Crushing injury of left little finger, initial encounter
S67.197D	Crushing injury of left little finger, subsequent encounter
S67.197S	Crushing injury of left little finger, sequela
S90.211A	Contusion of right great toe with damage to nail, initial encounter
S90.211D	Contusion of right great toe with damage to nail, subsequent encounter
S90.211S	Contusion of right great toe with damage to nail, sequela
S90.212A	Contusion of left great toe with damage to nail, initial encounter
S90.212D	Contusion of left great toe with damage to nail, subsequent encounter
S90.212S	Contusion of left great toe with damage to nail, sequela
S90.221A	Contusion of right lesser toe(s) with damage to nail, initial encounter
S90.221D	Contusion of right lesser toe(s) with damage to nail, subsequent encounter
S90.221S	Contusion of right lesser toe(s) with damage to nail, sequela
S90.222A	Contusion of left lesser toe(s) with damage to nail, initial encounter
S90.222D	Contusion of left lesser toe(s) with damage to nail, subsequent encounter
S90.222S	Contusion of left lesser toe(s) with damage to nail, sequela
S91.211A	Laceration without foreign body of right great toe with damage to nail, initial encounter
S91.211D	Laceration without foreign body of right great toe with damage to nail, subsequent encounter
S91.211S	Laceration without foreign body of right great toe with damage to nail, sequela
S91.212A	Laceration without foreign body of left great toe with damage to nail, initial encounter
S91.212D	Laceration without foreign body of left great toe with damage to nail, subsequent encounter
S91.212S	Laceration without foreign body of left great toe with damage to nail, sequela
S91.214A	Laceration without foreign body of right lesser toe(s) with damage to nail, initial encounter
S91.214D	Laceration without foreign body of right lesser toe(s) with damage to nail, subsequent encounter
S91.214S	Laceration without foreign body of right lesser toe(s) with damage to nail, sequela
S91.215A	Laceration without foreign body of left lesser toe(s) with damage to nail, initial encounter
S91.215D	Laceration without foreign body of left lesser toe(s) with damage to nail, subsequent encounter
S91.215S	Laceration without foreign body of left lesser toe(s) with damage to nail, sequela
S91.221A	Laceration with foreign body of right great toe with damage to nail, initial encounter
S91.221D	Laceration with foreign body of right great toe with damage to nail, subsequent encounter
S91.221S	Laceration with foreign body of right great toe with damage to nail, sequela
S91.222A	Laceration with foreign body of left great toe with damage to nail, initial encounter
S91.222D	Laceration with foreign body of left great toe with damage to nail, subsequent encounter
S91.222S	Laceration with foreign body of left great toe with damage to nail, sequela
S91.224A	Laceration with foreign body of right lesser toe(s) with damage to nail, initial encounter
S91.224D	Laceration with foreign body of right lesser toe(s) with damage to nail, subsequent encounter
S91.224S	Laceration with foreign body of right lesser toe(s) with damage to nail, sequela
S91.225A	Laceration with foreign body of left lesser toe(s) with damage to nail, initial encounter
S91.225D	Laceration with foreign body of left lesser toe(s) with damage to nail, subsequent encounter
S91.225S	Laceration with foreign body of left lesser toe(s) with damage to nail, sequela
S91.231A	Puncture wound without foreign body of right great toe with damage to nail, initial encounter
S91.231D	Puncture wound without foreign body of right great toe with damage to nail, subsequent encounter
S91.231S	Puncture wound without foreign body of right great toe with damage to nail, sequela
S91.232A	Puncture wound without foreign body of left great toe with damage to nail, initial encounter
S91.232D	Puncture wound without foreign body of left great toe with damage to nail, subsequent encounter
S91.232S	Puncture wound without foreign body of left great toe with damage to nail, sequela
S91.234A	Puncture wound without foreign body of right lesser toe(s) with damage to nail, initial encounter
S91.234D	Puncture wound without foreign body of right lesser toe(s) with damage to nail, subsequent encounter
S91.234S	Puncture wound without foreign body of right lesser toe(s) with damage to nail, sequela
S91.235A	Puncture wound without foreign body of left lesser toe(s) with damage to nail, initial encounter
S91.235D	Puncture wound without foreign body of left lesser toe(s) with damage to nail, subsequent encounter
S91.235S	Puncture wound without foreign body of left lesser toe(s) with damage to nail, sequela
S91.241A	Puncture wound with foreign body of right great toe with damage to nail, initial encounter
S91.241D	Puncture wound with foreign body of right great toe with damage to nail, subsequent encounter
S91.241S	Puncture wound with foreign body of right great toe with damage to nail, sequela
S91.242A	Puncture wound with foreign body of left great toe with damage to nail, initial encounter
S91.242D	Puncture wound with foreign body of left great toe with damage to nail, subsequent encounter
S91.242S	Puncture wound with foreign body of left great toe with damage to nail, sequela
S91.244A	Puncture wound with foreign body of right lesser toe(s) with damage to nail, initial encounter
S91.244D	Puncture wound with foreign body of right lesser toe(s) with damage to nail, subsequent encounter
S91.244S	Puncture wound with foreign body of right lesser toe(s) with damage to nail, sequela
S91.245A	Puncture wound with foreign body of left lesser toe(s) with damage to nail, initial encounter
S91.245D	Puncture wound with foreign body of left lesser toe(s) with damage to nail, subsequent encounter
S91.245S	Puncture wound with foreign body of left lesser toe(s) with damage to nail, sequela
S91.251A	Open bite of right great toe with damage to nail, initial encounter
S91.251D	Open bite of right great toe with damage to nail, subsequent encounter
S91.251S	Open bite of right great toe with damage to nail, sequela
S91.252A	Open bite of left great toe with damage to nail, initial encounter
S91.252D	Open bite of left great toe with damage to nail, subsequent encounter
S91.252S	Open bite of left great toe with damage to nail, sequela
S91.254A	Open bite of right lesser toe(s) with damage to nail, initial encounter
S91.254D	Open bite of right lesser toe(s) with damage to nail, subsequent encounter
S91.254S	Open bite of right lesser toe(s) with damage to nail, sequela
S91.255A	Open bite of left lesser toe(s) with damage to nail, initial encounter
S91.255D	Open bite of left lesser toe(s) with damage to nail, subsequent encounter
S91.255S	Open bite of left lesser toe(s) with damage to nail, sequela
S97.111A	Crushing injury of right great toe, initial encounter
S97.111D	Crushing injury of right great toe, subsequent encounter
S97.111S	Crushing injury of right great toe, sequela
S97.112A	Crushing injury of left great toe, initial encounter
S97.112D	Crushing injury of left great toe, subsequent encounter
S97.112S	Crushing injury of left great toe, sequela
S97.121A	Crushing injury of right lesser toe(s), initial encounter
S97.121D	Crushing injury of right lesser toe(s), subsequent encounter
S97.121S	Crushing injury of right lesser toe(s), sequela
S97.122A	Crushing injury of left lesser toe(s), initial encounter
S97.122D	Crushing injury of left lesser toe(s), subsequent encounter
S97.122S	Crushing injury of left lesser toe(s), sequela
T23.311A	Burn of third degree of right thumb (nail), initial encounter
T23.311D	Burn of third degree of right thumb (nail), subsequent encounter
T23.311S	Burn of third degree of right thumb (nail), sequela
T23.312A	Burn of third degree of left thumb (nail), initial encounter
T23.312D	Burn of third degree of left thumb (nail), subsequent encounter
T23.312S	Burn of third degree of left thumb (nail), sequela
T23.321A	Burn of third degree of single right finger (nail) except thumb, initial encounter
T23.321D	Burn of third degree of single right finger (nail) except thumb, subsequent encounter
T23.321S	Burn of third degree of single right finger (nail) except thumb, sequela
T23.322A	Burn of third degree of single left finger (nail) except thumb, initial encounter
T23.322D	Burn of third degree of single left finger (nail) except thumb, subsequent encounter
T23.322S	Burn of third degree of single left finger (nail) except thumb, sequela
T23.331A	Burn of third degree of multiple right fingers (nail), not including thumb, initial encounter
T23.331D	Burn of third degree of multiple right fingers (nail), not including thumb, subsequent encounter
T23.331S	Burn of third degree of multiple right fingers (nail), not including thumb, sequela
T23.332A	Burn of third degree of multiple left fingers (nail), not including thumb, initial encounter
T23.332D	Burn of third degree of multiple left fingers (nail), not including thumb, subsequent encounter
T23.332S	Burn of third degree of multiple left fingers (nail), not including thumb, sequela
T23.341A	Burn of third degree of multiple right fingers (nail), including thumb, initial encounter
T23.341D	Burn of third degree of multiple right fingers (nail), including thumb, subsequent encounter
T23.341S	Burn of third degree of multiple right fingers (nail), including thumb, sequela
T23.342A	Burn of third degree of multiple left fingers (nail), including thumb, initial encounter
T23.342D	Burn of third degree of multiple left fingers (nail), including thumb, subsequent encounter
T23.342S	Burn of third degree of multiple left fingers (nail), including thumb, sequela
T23.711A	Corrosion of third degree of right thumb (nail), initial encounter
T23.711D	Corrosion of third degree of right thumb (nail), subsequent encounter
T23.711S	Corrosion of third degree of right thumb (nail), sequela
T23.712A	Corrosion of third degree of left thumb (nail), initial encounter
T23.712D	Corrosion of third degree of left thumb (nail), subsequent encounter
T23.712S	Corrosion of third degree of left thumb (nail), sequela
T23.721A	Corrosion of third degree of single right finger (nail) except thumb, initial encounter
T23.721D	Corrosion of third degree of single right finger (nail) except thumb, subsequent encounter
T23.721S	Corrosion of third degree of single right finger (nail) except thumb, sequela
T23.722A	Corrosion of third degree of single left finger (nail) except thumb, initial encounter
T23.722D	Corrosion of third degree of single left finger (nail) except thumb, subsequent encounter
T23.722S	Corrosion of third degree of single left finger (nail) except thumb, sequela
T23.731A	Corrosion of third degree of multiple right fingers (nail), not including thumb, initial encounter
T23.731D	Corrosion of third degree of multiple right fingers (nail), not including thumb, subsequent encounter
T23.731S	Corrosion of third degree of multiple right fingers (nail), not including thumb, sequela
T23.732A	Corrosion of third degree of multiple left fingers (nail), not including thumb, initial encounter
T23.732D	Corrosion of third degree of multiple left fingers (nail), not including thumb, subsequent encounter
T23.732S	Corrosion of third degree of multiple left fingers (nail), not including thumb, sequela
T23.741A	Corrosion of third degree of multiple right fingers (nail), including thumb, initial encounter
T23.741D	Corrosion of third degree of multiple right fingers (nail), including thumb, subsequent encounter
T23.741S	Corrosion of third degree of multiple right fingers (nail), including thumb, sequela
T23.742A	Corrosion of third degree of multiple left fingers (nail), including thumb, initial encounter
T23.742D	Corrosion of third degree of multiple left fingers (nail), including thumb, subsequent encounter
T23.742S	Corrosion of third degree of multiple left fingers (nail), including thumb, sequela
T25.331A	Burn of third degree of right toe(s) (nail), initial encounter
T25.331D	Burn of third degree of right toe(s) (nail), subsequent encounter
T25.331S	Burn of third degree of right toe(s) (nail), sequela
T25.332A	Burn of third degree of left toe(s) (nail), initial encounter
T25.332D	Burn of third degree of left toe(s) (nail), subsequent encounter
T25.332S	Burn of third degree of left toe(s) (nail), sequela
T25.731A	Corrosion of third degree of right toe(s) (nail), initial encounter
T25.731D	Corrosion of third degree of right toe(s) (nail), subsequent encounter
T25.731S	Corrosion of third degree of right toe(s) (nail), sequela
T25.732A	Corrosion of third degree of left toe(s) (nail), initial encounter
T25.732D	Corrosion of third degree of left toe(s) (nail), subsequent encounter
T25.732S	Corrosion of third degree of left toe(s) (nail), sequela
T33.531A	Superficial frostbite of right finger(s), initial encounter
T33.531D	Superficial frostbite of right finger(s), subsequent encounter
T33.531S	Superficial frostbite of right finger(s), sequela
T33.532A	Superficial frostbite of left finger(s), initial encounter
T33.532D	Superficial frostbite of left finger(s), subsequent encounter
T33.532S	Superficial frostbite of left finger(s), sequela
T33.831A	Superficial frostbite of right toe(s), initial encounter
T33.831D	Superficial frostbite of right toe(s), subsequent encounter
T33.831S	Superficial frostbite of right toe(s), sequela
T33.832A	Superficial frostbite of left toe(s), initial encounter
T33.832D	Superficial frostbite of left toe(s), subsequent encounter
T33.832S	Superficial frostbite of left toe(s), sequela

Group 1 Medical Necessity ICD-10-CM Codes Asterisk Explanation

* Note: Report standalone ICD-10-CM code L60.8 for the indication of subungual abscess, subungual tumor, periungual tumor, subungual hematoma, or melanoma.

ICD-10-CM Codes that DO NOT Support Medical Necessity

Expand All | Collapse All

Group 1

(1 Code)

Group 1 Paragraph

All those not listed under the "ICD-10-CM Codes that Support Medical Necessity" section of this article.

Group 1 Codes

Code	Description
XX000	Not Applicable

ICD-10-PCS Codes

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code	Description
999x	Not Applicable

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code	Description
99999	Not Applicable

Other Coding Information

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format

Code	Descriptor Generic Name	Descriptor Brand Name	Exclusion Effective Date	Exclusion End Date	Reason for Exclusion
			N/A	N/A

Non-Excluded CPT/HCPCS Ended Codes - Table Format

Code	Descriptor Generic Name	Descriptor Brand Name	Exclusion Effective Date	Exclusion End Date	Reason for Exclusion

Revision History Information

Revision History Date	Revision History Number	Revision History Explanation
10/19/2023	R8	Article revised and published on 11/16/2023 effective for dates of service on and after 10/19/2023. The word “recently” has been changed to “previously” under Utilization Parameters discussing repeat nail excision. This is in response to an inquiry.
04/01/2023	R7	Article revised and published on 04/13/2023 effective for dates of service on and after 04/01/2023. Minor revisions have been made in the National Correct Coding Initiative (NCCI) Citation section and in the Coding Guidance section. The Utilization Parameters section of the article has been updated to indicate that for a medically reasonable and necessary repeat nail excision on the same finger or toe modifier KX may be reported if the medical record supports an indication for a repeat excision such as an ingrown nail of the opposite border or a new significant pathology on the same border recently treated.
06/06/2022	R6	Article revised and published on 06/02/2022 effective for dates of service on and after 06/06/2022. The ‘Utilization Parameters” section of the Article has been revised to remove the direction for the use of modifiers 76 and 77 and to add instructions that repeat services on the same nail, within 32 weeks, will be considered upon redetermination. Formatting changes made throughout the article.
01/30/2022	R5	Article revised and posted on 12/16/2021 effective for dates of service on and after 01/30/2022. Draft article posted on 07/29/2021.
09/26/2019	R4	Article revised and published on 09/26/2019 due to system changes in response to CMS Change Request 10901, this article has undergone some reorganization in the coding section and the following new fields have been added: CPT/HCPCS Modifier, Additional ICD-10 Information, and Other Coding Information.
04/18/2019	R3	Article revised and published on 04/18/2019 to add the CPT and ICD-10 codes from the related LCD, L34887 Surgical Treatment of Nails, in response to CMS Change Request 10901. The article was reformatted to place pertinent information toward the beginning of the article.
01/01/2017	R2	Article revised and published on 01/12/2017 effective for dates of service on and after 01/01/2017 to reflect the annual CPT/HCPCS code updates. For the following CPT/HCPCS code either the short description and/or the long description was changed. Depending on which description is used in this Article, there may not be any change in how the code displays in the document: 11750.
10/01/2015	R1	Article revised and published on 07/16/2015 to include reference to the Routine Foot Care LCD and Article, to include modifiers for the fingers and to provide direction regarding proper billing of CPT code 11765 for JL states DE, MD, NJ, PA and the District of Columbia. Article is new for the JH states AR, CO, LA, MS, NM, OK and TX.

Associated Documents

Related Local Coverage Documents
Articles
A58961 - Response to Comments: Surgical Treatment of Nails
LCDs
L34887 - Surgical Treatment of Nails

Updated On	Effective Dates	Status
11/09/2023	10/19/2023 - N/A	Currently in Effect	You are here
04/06/2023	04/01/2023 - 10/18/2023	Superseded	View
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Billing and Coding: Surgical Treatment of Nails

Document Note

Note History

Contractor Information

Article Information

General Information

CMS National Coverage Policy

Article Guidance

Response To Comments

Coding Information

Bill Type Codes

Revenue Codes

CPT/HCPCS Codes

Group 1

CPT/HCPCS Modifiers

Group 1

ICD-10-CM Codes that Support Medical Necessity

Group 1

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

ICD-10-PCS Codes

Group 1

Additional ICD-10 Information

Bill Type Codes

Revenue Codes

Other Coding Information

Group 1

Coding Table Information

Revision History Information

Associated Documents

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