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04/05/2024    

RESPONSES/COMMENTS (CODING AND BILLING) - PART 2


RE: Nail Avulsion Procedure and Guidelines CPT 11730 Local Coverage Reconsideration/ Challenge


From: Ralph Zicherman, DPM, Herman Zicherman, DPM


 


National Government Services, NGS.lcd.reconsideration@anthem.com


 


Nail infections and treatments have been recorded and written about for the past 4,000 years. Nail infections affect about 25 to 35 million patients per year in the United States, and are responsible for considerable complications, ranging from pain, swelling and inflammation, to limitations in ambulation, gangrene, amputation, and death.


 


The treatment for nail infections has been termed a partial nail avulsion, which up until the early ‘80s simply required the excision and removal of the infected nail segment for Medicare reimbursement. This was a simple effective treatment, with little complication or difficulty, for the temporary correction and treatment of a nail infection. Depending on the extent of...


 


Editor's note: This extended letter can be read here.

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