CPT code 11750 is a medical code used to describe a procedure in which a healthcare provider removes both the nail and the nail matrix. The nail matrix is the tissue from which the nail grows. The procedure is performed for severely deformed or ingrown nails. For example, a physician may use CPT code 11750 to remove an ingrown toenail permanently. It is incorrect to report CPT code 11750 with CPT code 11765 for the same digit on the same service date. CPT code 11765 requires an excision of a wedge of the skin of the nail fold from the involved side of the toe.
How often can you bill 11750?
CPT code 11750 can only be billed up to 6 times per service date. It’s recommended to use this code once per digit, even if a partial nail excision requires 2 incisions. A repeat nail excision can be performed on the same toe using CPT 11750 only if it’s on the opposite border or there’s a new, significant pathology. For both toes, append modifier -50 to the second 11750.
CPT 11750 reimbursement
The procedure involves removing the entire nail plate and destroying or permanently removing the matrix. The average patient pays $40 for this procedure, which includes facility and doctor fees.
What is the difference between CPT 11730 and 11750?
There are two different CPT codes, 11730 and 11750, that are utilized for nail procedures. Code 11730 is used for avulsion, which involves temporarily removing a nail and nail plate. On the other hand, code 11750 is used for excision, which is a permanent removal of a nail and nail matrix.
Code 11730 is used when the nail is expected to grow back, whereas code 11750 is for when the nail bed is destroyed and the nail won’t regrow. 11730 requires local anesthesia, while 11750 is used for partial avulsion and matrixectomy to remove the nail permanently.