2025 CPT code 11750
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Nails Integumentary System Feed
Partial or complete excision of the nail plate and matrix for permanent removal.
Modifiers F1-F9, FA, T1-T9, and TA may be used to identify the specific digit treated.Other modifiers may be necessary depending on the circumstances of the service.
Medical necessity for this procedure is established when conservative measures have failed to resolve symptoms or when the condition significantly impacts the patient's quality of life. The documentation should clearly support the need for surgical intervention.
The physician is responsible for prepping the patient, administering local anesthesia, excising the nail and nail matrix, and employing methods (electrocautery, phenol) to prevent regrowth.Suturing of any tears in the matrix may also be part of the physician's responsibility.
- Integumentary System
- Surgical Procedures on the Integumentary System > Surgical Procedures on the Nails
In simple words: The doctor removes part or all of a fingernail or toenail to stop it from growing back.This might involve using tools like scissors or a special burning tool to destroy the area where the nail grows from.
This procedure involves the surgical removal of a portion or all of the fingernail or toenail, encompassing the nail plate and matrix.The lunula is included in the excision if the removal is complete.Techniques may include the use of scissors and/or scalpels. To prevent regrowth, electrocautery or phenol may be used to destroy the nail matrix. Any tears in the matrix are closed with sutures.
Example 1: A patient presents with an ingrown toenail causing significant pain and inflammation. The physician performs a partial excision of the nail and matrix to relieve symptoms and prevent recurrence., A patient experiences a traumatic injury resulting in a partially avulsed toenail with significant damage to the nail matrix. The physician performs a complete excision of the nail and matrix to remove damaged tissue and prevent infection., A patient has a deformed toenail that doesn't respond to conservative management. The physician performs a complete excision of the nail and matrix for permanent removal, using electrocautery to prevent regrowth.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- RVU: Refer to the current Medicare Physician Fee Schedule for RVU values and reimbursement information.These values can vary by geographic location and other factors.
- Global Days: The global period is dependent on payer specific guidelines and may vary.Consult local Medicare Administrative Contractor (MAC) guidelines for specific information.
- Payment Status: Active
- Modifier TC rule: The use of a technical component (TC) modifier is dependent on the services performed and the individual provider's role. Consult payer guidelines for specific guidance.
- Fee Schedule: Historical fee schedules are unavailable, consult with your payer or use a fee schedule database to determine previous fee information.
- Specialties:Podiatry, Dermatology, General Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgery Center