Editor’s Note: Cutting through the red tape to make certain that you get paid for every dollar you earn has become more difficult than ever, particularly in our current climate of health care reform and ICD-10 transition. The ACEP Coding and Nomenclature Committee has partnered with ACEP Now to provide you with practical, impactful tips to help you navigate through this coding and reimbursement maze.
Question: Are there different codes for managing nail problems?
Answer: Nail and nail bed procedures may be required for injuries or medical conditions. Injuries may include contusions, nail damage, and nail bed lacerations. A fingertip contusion may result in a subungual hematoma requiring trephination to relieve pressure and pain. Drainage may be achieved by drilling the nail with a needle or with cautery, which is reported with Current Procedural Terminology (CPT) code 11740 (evacuation of subungual hematoma, 0.92 relative value units [RVUs], Medicare $33.16).
When damage to the nail is extensive and removal is required, report it with CPT code 11730 (avulsion of nail plate, partial or complete, simple, single, 1.58 RVUs, Medicare $56.94). Report each additional nail with the add-on code 11732 (avulsion of nail plate, partial or complete, simple, additional nail plate, 0.51 RVUs, Medicare $18.38). If a nail bed injury requires repair, report it with 11760 (repair of nail bed, 3.27 RVUs, Medicare $117.84). Note that when an avulsion is performed to facilitate a nail bed repair, it is bundled and not separately reportable.