11740 CPT code description

11740 CPT code description

A subungual hematoma is a common problem that healthcare professionals address using the medical code CPT 11740. This condition occurs when blood collects underneath a fingernail or toenail due to different factors like injuries, fungal infections, or growths. It helps doctors identify and treat the problem effectively.

Also read: 11730 CPT code description.

Identifying the Issue

In the medical world, the code ICD-9 923.3 is used to describe this condition as a contusion in the upper limb or finger. It’s a way for medical professionals to pinpoint and understand the injury.

Important Note

This code has a global indicator of “000,” which simply means that it’s considered a minor surgical procedure according to the CMS NCCI Correct Coding Manual.

When to Use CPT 11740

Medical practitioners use this code when they need to figure out the cause of a subungual hematoma and provide the right care for their patients. It’s a helpful tool for delivering the proper treatment.

When Not to Use CPT 11740

There are times when it’s not suitable to use CPT code 11740. These include situations where there’s an active infection near the nail, severe peripheral vascular disease, or severe neuropathy. In these cases, alternative approaches may be needed.

Getting Paid for CPT 11740

In terms of payment, it’s good to know that the 2021 National Physician Fee Schedule provides clear guidelines for how much healthcare professionals can expect to be reimbursed for using CPT code 11740. The reimbursement typically falls in the range of $70.00 to $115.50.

As a side note, the American Medical Association establishes and maintains CPT codes, and organizations like CMS use these codes to reimburse healthcare providers. To find the specific CPT billing code, you can check your healthcare provider’s billing statement or download a list of the 2022 HCPCS codes for easy reference.

Do You Need a Modifier for CPT 11740?

In certain cases, it may be necessary to include modifiers such as -59 or XS to CPT codes. Such modifiers signify that a specific service or procedure was conducted autonomously and distinctly from other services or procedures in the same session or was executed by more than one physician or at different locations. This is a means of guaranteeing precise billing and record-keeping.

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