Routine Foot Care and Debridement of Nails (L33636) (2024)

FAQs

What is routine foot care and debridement of nails? ›

Routine foot care includes the cutting or removal of corns and calluses, clipping, trimming, or debridement of nails, including debridement of mycotic nails, shaving, paring, cutting, or removal of keratoma, tyloma, and heloma.

ICD-10-CM code L60. 2 is included as covered in the LCD and provides greater specificity for reporting onychogryphosis and onychauxis. The groups of ICD-10-CM codes in the “ICD-10-CM Codes that Support Medical Necessity” section have been renumbered. ICD-10-CM codes B35.

Medicare will cover debridement of nail(s) by any method(s); 1 to 5 and/or debridement of nail(s) by any method(s); 6 or more no more often than every 60 days.

Biological, enzymatic, and autolytic debridement usually cause little pain, if any. Mechanical and sharp debridement can be painful. If you're getting mechanical debridement, you may receive pain medication.

Nail debridement: the significant reduction in the thickness and length of the toenail with the aim of allowing the patient to ambulate without pain. Nail debridement is a distinct service from “routine foot care.” Simple trimming of the end of the toenails by cutting or grinding is not debridement.

Medicare will cover the treatment of corns, calluses, and toenails once every 61 days in persons having certain systemic conditions. Examples of such conditions include: Diabetes with peripheral arterial disease, peripheral arterial disease, peripheral neuropathy, and chronic phlebitis.

Nail debridement involves removal of a diseased toenail bed or viable nail plate. This may be performed manually with an instrument, or with an electric grinder.

Debridement of Nail Coding Criteria

Procedure Code 11720 or 11721 are included in Medicare's covered foot care when billed with a diagnosis pertaining to debridement of nail.

CPT code 11721 is defined as: Debridement of nail(s) by any method(s); 6 or more. This CPT code is billed when “At Risk,” routine foot care (RFC) is performed and also when symptomatic mycotic toenails are debrided. HCPCS Level II code G0127 is defined as: Trimming of dystrophic nails, any number.

What is the CPT code for toenail treatment? ›

Procedure code 11730 (Avulsion of nail plate, partial or complete, simple; single) is reported when removing part of the nail plate or the entire nail plate.

There is a code for a lacerated nail bed repair- the correct CPT code to bill is 11760 (repair of nail bed).

Medicare will cover toenail cutting with a podiatrist. Beneficiaries can schedule a toenail cutting every 61 days as long as they meet Medicare requirements for toenail cutting. You must have a health condition that deems this service necessary, as Medicare won't cover toenail cutting for healthy people.

Callus debridement is clearly an important ulcer prevention strategy. The scalpel skills used by the podiatrist to remove callus are best suited to achieve safe, local sharp wound debridement.

We all need to cut our toenails every six to eight weeks.

These include surgical debridement, biological debridement, enzymatic debridements, and autolytic debridement.

Do not shower for at least 24 hours after the procedure or for as long as your doctor tells you to. When you shower, keep your dressing and wound dry. Do not take a bath, swim, use a hot tub, or soak your affected body part until your wound has healed.

Debridement is the word used to describe a specific surgical procedure. In a debridement, the surgeon removes damaged tissue from the body to promote healing. Tissue removed may be: Dead.

Dystrophic nails can be thinned through manual sanding, however, the quickest and most effective way to sand very thick toenails is with an electric sanding device. Thick nails should be sanded to avoid ulcerations due to shoe pressure, and can be sanded as thin as you desire.

Can you file down thickened toenails? ›

Thick toe nails can be managed using an emery board and filing your nails. This will stunt nail growth and keep them manageable. Gently file each nail across the thickened part 2-3 time weekly to reduce the thickness. The best time to do this is when the nail is dry, before a bath or shower.

Visit a Podiatrist

If you can't trim your own toenails, a podiatrist can do that during your visit. If you are a senior and a diabetic, it's vital that you avoid trimming your own toenails to lower your risk for developing an infection in your feet.

Although cutting toenails improperly causes a lot of problems, so does not cutting them at all. “If you were to never cut them, they would curve down and follow the toes. It would get pretty uncomfortable and dirty.” But not all toenail injuries are self-inflicted or inherited.

If you have a difficult to treat fungal nail infection, or if you have a suppressed immune system or diabetes, your podiatrist may recommend removal of the affected toenail to prevent the infection from spreading to other toenails or beyond your feet.

Treatment usually begins with your dermatologist trimming your infected nail(s), cutting back each infected nail to the place where it attaches to your finger or toe. Your dermatologist may also scrape away debris under the nail. This helps get rid of some fungus.

It may be hard to imagine anything remedying the situation. Outright removing your toenails, however, is the absolute last resort option for treating toenail fungus, and only performed in very rare cases.

Effective products include efinaconazole (Jublia), tavaborole (Kerydin) and ciclopirox (Penlac). All require daily applications, and it may take as long as a year to see noticeable improvement. These products may work for early, superficial fungal infections because they kill fungi on the surface of the nail.

Routine foot care includes: Cutting or removing corns and calluses. Trimming, cutting, or clipping nails. Hygienic or other preventive maintenance, like cleaning and soaking your feet.

First and foremost – for any wound to be covered it must either be a surgical wound or, at some point, have been debrided. Any form of debridement (surgical, chemical, mechanical, or autolytic) will qualify a wound for coverage.

Routine foot care services are considered medically necessary once (1) in 60 days. More frequent services will be considered not medically necessary. Services for debridement of more than five nails in a single day may be subject to special review.

What is the CPT code for foot debridement? ›

Debridement including removal of foreign material at the site of an open fracture or open dislocation may be reported with CPT codes 11010-11012.

CPT 11011. This indicates debridement including removal of foreign material in skin, subcutaneous tissue, muscle fascia and muscle.

So, taking a sample of the nail tissue with a simple clipping allows us the tissue needed for such a test. This is NOT a biopsy. This is a clipping for which payment is includ- ed in our trimming, debridement, or perhaps even in our E&M service. Be judicious in the use of CPT code 11755.

CPT Code(s):

88312.

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).

For a nail biopsy the correct CPT code is 11755-Biopsy of nail unit (e.g., plate, bed, matrix, hyponychium, proximal and lateral nail folds).

The Current Procedural Terminology (CPT^®) code 28001 as maintained by American Medical Association, is a medical procedural code under the range - Incision Procedures on the Foot and Toes.

11730 or a 11750 if used phenol or other matrixectomy procedure. Lay Description (Code): The physician avulses a nail plate partially or completely.

The growth rate of nails decreases when people get older. This results in thickening because nail cells pile up. The process of nail cells piling up is referred to as onychocytes. Another reason why fingernails don't thicken as much is their growth rate is smaller than the growth rate of toenails.

Podiatry treatment for thickened toenails

Our podiatrists regularly reduce thickened toenails as part of a general foot care treatment (medical pedicure). This involves nail cutting, removal of corns and callus, followed by application of a heel balm, making your feet feel great again.

Will a toenail grow back if a podiatrist removes it? ›

After medical removal

Surgical removal of a nail might be necessary with severe fungus, recurrent ingrown toenails, or when a large section of a nail is diseased or damaged. After medical removal, it can take up to 18 months for a nail to fully regrow.

You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on. The procedure will take about 20 to 30 minutes.

On MDsave, the cost of a Debridement (non-selective) ranges from $204 to $303.

In-office debridement is often performed every one to two weeks, depending on the type of wound. It's possible debridement won't be needed more than once; in fact, excessive debridement harms the healing process.

Clipping nails while wet

The trouble is, your nails are likely to bend or tear when you try to cut them, and you run the risk of injury. Unless you have thick toenails, which soften in the bath, you should cut them when they're dry to ensure a clean cut.

This is important, because cutting your toenails too short could heighten your risk for ingrown toenails. If you leave your toenails too long, they are more likely to get caught on something and tear. It's recommended that you maintain your toenails at a length of about 1 to 2 millimeters (0.04 to 0.08 inches).

Your podiatrist can help you take care of not only your feet and ankles, but also your toenails. One very common condition that podiatrists treat are fungal toenail infections.

Nail debridement involves removal of a diseased toenail bed or viable nail plate. This may be performed manually with an instrument, or with an electric grinder. Podiatrists generally provide nail debridement to patients diagnosed with onychomycosis (i.e., mycosis or mycotic toenails).

Either the entire nail (avulsion) or part of the nail (debridement) can be removed. This procedure is almost always painless. Your doctor will first place cloth adhesive tape on the normal skin around the infected nail. A urea ointment is then put directly on the nail surface and covered with plastic and tape.

Routine foot care includes: Cutting or removing corns and calluses. Trimming, cutting, or clipping nails. Hygienic or other preventive maintenance, like cleaning and soaking your feet.

What is foot debridement? ›

Debridement is a procedure used to clean out dead or infected skin and tissue from a foot ulcer. It allows your doctor to assess the extent of the soft tissue damage and encourage healing. To perform this procedure, a doctor uses a sharp tool, such as a scalpel, to remove tissue from within and around the wound.

Debridement is generally a safe procedure, but there is always a risk of complications. Some possible risks from debridement include. It will be important to follow your doctor's instructions about caring for your wound after a debridement procedure. Proper wound care will reduce your risk of infection.

You can expect some pain and swelling around your wound. This should get better within a few days after the procedure. You may have a bandage or a moist dressing over your wound. Your doctor will let you know how long to keep it on and how often to change it.

Studies show that taking antifungal pills and applying medicine to your nails can be more effective than using either treatment alone. Nail removal: If you have a severe infection or other treatments just don't work, your dermatologist may recommend removing the nail(s) to get rid of the infection.

Your doctor will give you an injection in the finger or toe to prevent pain. Then your doctor will use a tool to loosen the skin around the nail and separate the nail from the skin. If only part of the nail is diseased, only the diseased part is removed.

There could be some discomfort during activities within the first week after toenail removal. Avoid hot tubs, swimming pools, or lakes during this 1-2 week recovery time.

Medicare will cover the treatment of corns, calluses, and toenails once every 61 days in persons having certain systemic conditions. Examples of such conditions include: Diabetes with peripheral arterial disease, peripheral arterial disease, peripheral neuropathy, and chronic phlebitis.

Medicare Part B will cover "medically necessary" services, including doctor visits and care in an outpatient setting for toenail fungus diagnosis and treatment.

At the hospital or surgery center

You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on. The procedure will take about 20 to 30 minutes.

Wound debridement may be done under a local, regional or general anaesthetic. Regional and local anaesthesia completely blocks pain from the wound area and you will stay awake during the procedure. If you have general anaesthesia, this means you will be asleep during the procedure.