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Official Description

Evacuation of subungual hematoma

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 11740 involves the evacuation of a subungual hematoma, which is a collection of blood that accumulates beneath a fingernail or toenail. This condition typically arises due to blunt trauma to the nail, such as from an injury or impact that causes bleeding under the nail plate. The physician performs this procedure to relieve pressure, alleviate pain, and promote healing by removing the trapped blood. During the procedure, an electrocautery unit is utilized to create a small opening in the nail plate, allowing the accumulated blood to drain out effectively. Following the drainage, the wound is wrapped to facilitate continued drainage and protect the area as it heals. This intervention is crucial for restoring comfort and preventing complications associated with prolonged pressure from the hematoma.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The evacuation of a subungual hematoma, as indicated by CPT® Code 11740, is performed under specific circumstances. The primary indications for this procedure include:

  • Blunt Trauma to the Nail: The procedure is indicated when there is a collection of blood beneath the nail due to an injury, which can cause significant pain and pressure.
  • Severe Pain: Patients experiencing intense discomfort from the pressure of the hematoma may require this procedure to alleviate their symptoms.
  • Visible Hematoma: The presence of a noticeable subungual hematoma that affects the nail's appearance and function is a clear indication for intervention.

2. Procedure

The procedure for the evacuation of a subungual hematoma involves several critical steps to ensure effective drainage and patient safety. The steps are as follows:

  • Step 1: The physician begins by assessing the affected nail and surrounding area to determine the extent of the hematoma and the appropriate approach for drainage.
  • Step 2: After confirming the need for intervention, the area is prepared and cleaned to minimize the risk of infection. Local anesthesia may be administered to ensure patient comfort during the procedure.
  • Step 3: An electrocautery unit is then used to carefully pierce the nail plate. This technique allows for a controlled opening that minimizes damage to the surrounding tissue while effectively accessing the hematoma.
  • Step 4: Once the nail plate is punctured, the trapped blood is allowed to drain out. The physician may gently manipulate the area to facilitate complete evacuation of the hematoma.
  • Step 5: After the drainage is complete, the wound is wrapped with a sterile dressing. This dressing not only protects the area but also allows for continued drainage, which is essential for proper healing.

3. Post-Procedure

Following the evacuation of a subungual hematoma, patients can expect specific post-procedure care and considerations. The wrapped area should be kept clean and dry to prevent infection. Patients are typically advised to monitor for any signs of complications, such as increased pain, swelling, or discharge. It is important to follow up with the physician if any concerning symptoms arise. Recovery time may vary depending on the extent of the hematoma and the individual’s healing process, but most patients can resume normal activities relatively quickly, provided they take care to protect the affected nail during the healing period.

Short Descr DRAIN BLOOD FROM UNDER NAIL
Medium Descr EVACUATION SUBUNGUAL HEMATOMA
Long Descr Evacuation of subungual hematoma
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard 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 STV-Packaged Codes
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 2
CCS Clinical Classification 168 - Incision and drainage, skin and subcutaneous tissue
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.
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).
TA Left foot, great toe
T5 Right foot, great toe
T1 Left foot, second digit
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
T6 Right foot, second digit
T7 Right foot, third digit
T2 Left foot, third digit
T4 Left foot, fifth digit
T9 Right foot, fifth digit
GW Service not related to the hospice patient's terminal condition
T8 Right foot, fourth digit
T3 Left foot, fourth digit
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.)
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.
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.
RT Right side (used to identify procedures performed on the right side of the body)
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
63 Procedure performed on infants less than 4 kg: procedures performed on neonates and infants up to a present body weight of 4 kg may involve significantly increased complexity and physician or other qualified health care professional work commonly associated with these patients. this circumstance may be reported by adding modifier 63 to the procedure number. note: unless otherwise designated, this modifier may only be appended to procedures/services listed in the 20100-69990 code series and 92920, 92928, 92953, 92960, 92986, 92987, 92990, 92997, 92998, 93312, 93313, 93314, 93315, 93316, 93317, 93318, 93452, 93505, 93563, 93564, 93568, 93569, 93573, 93574, 93575, 93580, 93581, 93582, 93590, 93591, 93592, 93593, 93594, 93595, 93596, 93597, 93598, 93615, 93616 from the medicine/ cardiovascular section. modifier 63 should not be appended to any cpt codes listed in the evaluation and management services, anesthesia, radiology, pathology and laboratory, or medicine sections (other than those identified above from the medicine/cardiovascular section).
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AM Physician, team member service
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
ER Items and services furnished by a provider-based, off-campus emergency department
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
GJ "opt out" physician or practitioner emergency or urgent service
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
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
SG Ambulatory surgical center (asc) facility service
TL Early intervention/individualized family service plan (ifsp)
TR School-based individualized education program (iep) services provided outside the public school district responsible for the student
U7 Medicaid level of care 7, 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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Pre-1990 Added Code added.
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