In a certain circumstance, a individual provides for a adhere to-up of an ingrown toe nail. The podiatrist finds that the individual now has two ingrown toenails – one on each foot. He removes both of those from each and every toe and also did a silver nitrate cauterization. How need to I report this? Should I report 99212-25?
Effectively, the reply is certainly. Aside from coding 99212-25, you must bill 11750 (Excision of nail and nail matrix, partial or complete [example, ingrown or deformed nail], for long-lasting elimination) appended by modifier 50 (Bilateral technique).
Logic for evaluation & administration: Due to the fact the analysis is new to one toe, you could justify 99212 (Business or other outpatient check out for the E/M of an set up affected person which needs at least two of these 3 important parts: a trouble concentrated history a challenge centered examination, and clear-cut clinical decision earning Substantial, individually identifiable E/M company by the same doctor on the very same working day of the technique or other company). The individual presents for abide by-up of one ingrown toenail. However, the podiatrist has not examined the other (new) ingrown toenail earlier.
Including modifier 25 (Substantial, individually identifiable E&M provider by the exact doctor on the similar working day of the method or other assistance) to 99212 suggests the podiatrist carries out a important, different support from the ingrown toenail removing.
Logic for incision: You should really report each toenail removing: 11750 for the to start with comprehensive removing and 11750 for the 2nd elimination. Working with modifier 50 to the second elimination tells the insurance company that the podiatrist carries out the toe elimination as bilateral treatment.
For extra specialty-distinct content to assistance your podiatry coding, continue to be tuned to a professional medical coding resource like Coding Institute.