2025 CPT code 11765
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Nails Surgery/Integumentary System Feed
Wedge excision of skin of nail fold (e.g., for ingrown toenail).
Modifiers are applicable. Use appropriate modifiers for laterality (RT/LT) if necessary. Modifiers for toe and finger: use modifiers T1-T9 and TA to specify the affected toe on the left foot. Use modifiers F1-F9 and FA for fingers
Medical necessity for this procedure is established when conservative treatments have failed or are contraindicated, and the patient is experiencing pain, inflammation, infection, or other complications due to the ingrown toenail. The medical record should clearly document the symptoms, failed conservative treatments (if any), and the clinical rationale for the surgical intervention.
The physician is responsible for administering local anesthesia, making the incisions, removing the wedge of skin, and closing the wound with sutures.
In simple words: The doctor removes a small, wedge-shaped piece of skin from the side of the toenail to treat an ingrown nail. This helps the nail grow correctly and prevents it from digging into the skin.
This procedure involves the surgical removal of a wedge-shaped piece of skin from the nail fold, typically used to treat ingrown toenails. It does not include excision of the nail plate or matrix.After administering local anesthesia, an elliptical incision is made through the subcutaneous tissue of the affected nail groove. A wedge-shaped piece of skin is removed, and the wound is closed with sutures.
Example 1: A patient presents with an ingrown toenail on the great toe of the left foot, with pain, redness, and swelling. The physician performs a wedge excision of the nail fold (11765-TA) to remove the ingrown portion and allow the nail to grow properly., A patient has recurrent ingrown toenails on the third toe of the right foot, despite conservative treatment. The physician performs a wedge excision (11765-T7) to permanently resolve the issue., A patient with diabetes develops an ingrown toenail with signs of early infection. The physician performs a wedge excision (11765) along with appropriate antibiotic therapy to prevent complications.
Documentation should include the location of the ingrown toenail (e.g., which toe and foot), the severity of the condition (e.g., presence of infection, granulation tissue), the administration of local anesthesia, the method of excision, and the wound closure technique.
** This procedure is considered a minor surgical procedure and is usually performed under local anesthesia in an office or outpatient setting.
- Revenue Code: P6A - MINOR PROCEDURES - SKIN
- Global Days: 10 days
- Payment Status: Active
- Specialties:Podiatry, Dermatology, Family Medicine, General Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center