2025 ICD-10-CM code L60.1
Onycholysis is the separation of the nail plate from the nail bed.
Medical necessity for the evaluation and treatment of onycholysis is established when the condition significantly impacts a patient's quality of life or poses a risk of complications, such as secondary infection or pain.The need for diagnostic testing or specialist referral should be justified based on the clinical presentation and suspected underlying cause.
Diagnosis and management of onycholysis typically falls under the purview of dermatologists or primary care physicians.Clinical responsibility includes identifying the underlying cause, ruling out other conditions, and recommending appropriate treatment.This may involve laboratory tests, imaging studies, or referral to other specialists.
In simple words: Onycholysis is a condition where the nail separates from the nail bed underneath it, usually creating a white or opaque area.
Onycholysis is a common nail disorder characterized by the detachment of the nail plate from the nail bed, often starting at the distal edge and/or lateral attachments. This separation creates a subungual space that can accumulate debris and moisture, increasing the risk of secondary infections.It can affect fingernails or toenails.
Example 1: A 35-year-old female presents with a several-month history of progressive separation of the right thumbnail from the nail bed. There's no history of trauma, and she reports frequent handwashing due to her job as a healthcare worker.The clinician diagnoses onycholysis, likely due to chronic water exposure, and recommends minimizing water exposure and keeping the nails dry., A 50-year-old male with psoriasis presents with thickening, discoloration, and separation of several toenails. The clinician diagnoses onycholysis secondary to psoriasis and prescribes topical corticosteroids for the underlying psoriasis., A 20-year-old female presents with onycholysis of several fingernails after starting a new medication. The physician suspects a drug-induced reaction and recommends discontinuing the medication, with a plan to monitor the nail changes over time.
Documentation for onycholysis should include:1. Detailed description of the affected nails, including the location and extent of separation.2. Presence of any discoloration, debris, or signs of infection.3. Patient history, including any trauma, underlying medical conditions (like psoriasis, thyroid disease), medications, and occupational exposures.4. Results of any diagnostic tests performed (e.g., fungal cultures, biopsies).5. Treatment plan and patient education provided.
** Onycholysis can sometimes be confused with other nail conditions, so a thorough evaluation is essential for accurate diagnosis and management.Appropriate treatment depends on the underlying cause, and can range from conservative measures like avoiding trauma and irritants to medical interventions for underlying systemic conditions or infections.
- Specialties:Dermatology, Primary Care, Podiatry
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital