Nail bed biopsy and repair of nailbed

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Shoshana
Posts: 85
Joined: Fri Jun 23, 2017 1:41 pm
Location: Multi-specialty Clinic

Sun Jul 01, 2018 2:41 pm

I have a patient with a subungual pigmented area which I biopsied.

I removed the nail plate, and biopsied the nail bed, 11755.

The resultant nailbed defect was too wide to close primarily so I undermined widely the entire nailbed, allowing closure. I'd like to also bill 11760. Thoughts?
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admin
Site Admin
Posts: 448
Joined: Mon Apr 09, 2012 1:54 pm

Thu Jul 05, 2018 2:23 pm

Good Afternoon-

I think this scenario will support billing for both procedures as long as the documentation adequately shows the reason and extra work involved in that more complex repair (the description sent in the question was a great way to word that).

An NCCI edit does exist between codes 11755 and 11760, but they can be billed together with a -59 modifier on 11755.

Your question has been answered by Stephanie Allard, CPC, CEMA, RHIT
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