2025 CPT code 11730
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Simple, partial or complete avulsion of a single nail plate.
Modifiers F1-F9, FA (hand) and T1-T9, TA (foot) can be used to specify the location of the nail.Modifiers 22, 51, 52, 59, 78, 79, and others may be applicable depending on the specific circumstances of the procedure.Refer to the CPT manual for detailed guidelines.
Medical necessity is established by the presence of a nail disorder causing significant pain, inflammation, or infection. Documentation should clearly demonstrate that the removal of the nail plate is necessary for appropriate treatment and resolution of the underlying condition. The procedure must align with clinical guidelines and payer-specific requirements.
The physician performs the surgical removal of the nail plate, controls bleeding (potentially using electrocautery), and performs simple wound repair.The physician is responsible for pre-operative assessment, administration of local anesthesia, and post-operative care.
In simple words: The doctor removes part or all of one fingernail or toenail. This involves carefully separating the nail from the nail bed and then stopping any bleeding. Minor repairs to any small cuts are also included.
This CPT code describes the surgical removal of part or all of a single nail plate using simple avulsion techniques.The procedure involves separating the nail plate from the nail bed using instruments like a nail elevator or iris scissors. Electrocautery may be used to control bleeding, and simple wound repair is included.This code is for the initial removal of a single nail plate; additional nail plates require the use of add-on code 11732.The removal of the nail matrix is not included in this code.Modifiers F1-F9, FA, T1-T9, and TA may be used to specify the location of the nail.
Example 1: A patient presents with an ingrown toenail causing significant pain and inflammation. The physician performs a partial avulsion of the affected nail plate to relieve pressure and allow for healing., A patient sustains a crush injury to their fingernail resulting in a partially detached nail plate. The physician performs a complete avulsion of the damaged nail plate., A patient has a severe case of paronychia (infection around the nail) requiring removal of a portion of the nail plate to facilitate drainage and treatment of the infection.
Detailed medical history including the onset and nature of the nail disorder.A clear description of the surgical procedure performed, including the extent of nail plate removal and any associated wound repair.Photographs or other images of the nail pre- and post-operatively could support the documentation.Properly documented diagnosis codes supporting medical necessity.Postoperative care instructions provided to the patient.
** Careful documentation is crucial to ensure appropriate coding and reimbursement.The use of add-on code 11732 for additional nail plates must be justified by the clinical documentation.Always refer to the most up-to-date CPT manual and payer-specific guidelines for complete and accurate coding.
- Revenue Code: P6A (Minor Procedures - Skin)
- RVU: Not specified in provided data.Consult current CMS conversion factors and local payer guidelines for reimbursement rates.
- Global Days: Not specified in provided data. Consult local payer guidelines.
- Payment Status: Active
- Modifier TC rule: The provided information doesn't specify if a Technical Component (TC) modifier applies. The determination depends on payer specific rules and the involvement of other healthcare professionals.
- Fee Schedule: Not specified in provided data. Consult historical CMS fee schedules and local payer guidelines.
- Specialties:Podiatry, Dermatology, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)