Cracking the Code
CPT Coding for Ingrown Toenails
One of the main diagnoses seen in diseases of the nail is an ingrown toenail (L60.0). Mayo Clinic describes ingrown toenails as a common condition in which the corner or side of a toenail grows into soft flesh. The result is pain, inflamed skin, swelling, and, sometimes, an infection. Ingrown toenails usually affect the big toe.
If the pain is severe or spreading, the doctor can take steps to relieve the discomfort and help avoid complications of ingrown toenails.
If a patient has diabetes or another condition that causes poor blood flow to their feet, they’re at greater risk of complications of ingrown toenails.
The excision of a nail and nail matrix (11750) is performed for severely deformed or ingrown nails. This procedure may be performed using surgical, laser, electrocautery, or chemical techniques, following the administration of a local anesthetic.
Q: A 47-year-old patient has a terrible problem with ingrown toenails. The patient goes to his podiatrist to have a nail permanently removed along with the nail matrix. What CPT code is reported?
A: 11750. In our CPT Index, we want to look for Removal/Nails which directs us to two code ranges 11730-11732 & 11750. The documentation states the entire nail and root (nail matrix) are removed. In the numeric section of the CPT, the removal of the nail and nail matrix is code 11750. There is no mention of removing a wedge of restrictive skin in the nail fold to relieve the ingrown toenail
Reference: FY 2022 CPT book, Mayo Clinic