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A simple avulsion of the nail plate, whether partial or complete, is a surgical procedure aimed at removing the nail plate from the nail bed. This procedure is typically performed when there is a need to address issues such as infection, trauma, or other conditions affecting the nail. During the procedure, a Freer elevator is utilized, which is a specialized surgical instrument designed to separate tissues. The elevator is inserted under the edge of the nail plate, allowing the surgeon to lift the nail until a plane of cleavage is formed between the nail bed and the nail plate. This cleavage is then extended proximally to the nail matrix, which is the tissue under the base of the nail that produces new nail cells. The lateral margins of the nail are freed by moving the elevator in a side-to-side motion, ensuring that the nail is completely detached from the surrounding tissue. Once the lateral margins are adequately separated, the elevator is inserted under the cuticle, and the same side-to-side motion is applied. Finally, the nail is grasped with a hemostat, a clamp used to hold tissues, and avulsed using a rolling-twisting motion. It is important to note that CPT® Code 11732 is specifically used for each additional nail plate avulsion performed, following the primary procedure coded with CPT® Code 11730 for a single nail plate avulsion.
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The procedure of nail plate avulsion is indicated for various conditions that may affect the health and integrity of the nail. These indications include:
The procedure for avulsion of the nail plate involves several key steps that ensure the safe and effective removal of the nail. These steps include:
After the avulsion procedure, the patient may experience some discomfort and swelling in the area. It is important to provide appropriate post-procedure care, which may include keeping the area clean and dry, applying topical antibiotics if prescribed, and monitoring for signs of infection. Patients are typically advised to avoid putting pressure on the affected area and to follow up with their healthcare provider for any necessary wound care or further evaluation. Recovery time may vary depending on the individual and the extent of the procedure, but most patients can expect to resume normal activities within a few days, barring any complications.
| Short Descr | REMOVE NAIL PLATE ADD-ON | Medium Descr | AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL | Long Descr | Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 4 | CCS Clinical Classification | 174 - Other non-OR therapeutic procedures on skin and breast |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 11730 | MPFS Status: Active Code APC Q1 ASC N1 Physician Quality Reporting CPT Assistant Article Illustration for Code Avulsion of nail plate, partial or complete, simple; single |
| T5 | Right foot, great toe | TA | Left foot, great toe | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | T6 | Right foot, second digit | T1 | Left foot, second digit | T7 | Right foot, third digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | T3 | Left foot, fourth digit | T8 | Right foot, fourth digit | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | T9 | Right foot, fifth digit | T2 | Left foot, third digit | GW | Service not related to the hospice patient's terminal condition | T4 | Left foot, fifth digit | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q8 | Two class b findings | Q9 | One class b and two class c findings | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | TF | Intermediate level of care | TL | Early intervention/individualized family service plan (ifsp) | TT | Individualized service provided to more than one patient in same setting | UD | Medicaid level of care 13, as defined by each state | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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