Podiatry Coding & Billing Alert

Nail Debridement: 11720-11721 With E/M? Follow These Tips for Clean Coding


- Published on Fri, Feb 10, 2012

Are these myths costing you $70 per procedure?

Auditors look unkindly on podiatry offices that incorrectly code E/M services and nail debridement procedures performed during a single patient encounter -- but that doesn't mean you should pass up legitimate opportunities to code both. We've got the scoop on when you can report both services and the modifier that will make the grade.

Myth: You may never code for both an E/M and a nail debridement when submitting claims to Medicare.

Reality: The blanket statement that you may never report an E/M code and a nail debridement code together is simply not true. You absolutely can code and bill an E/M service and a nail debridement for a single patient encounter, depending on the situation.

Key: You must have documentation that the podiatrist performed two entirely separate services. Most carriers also require that you append modifier 25 (Significant, separately identifiable evaluation and [...]

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