tci Part B Insider - 2004 Issue 9

Nail Debridement: Show "Sick Foot" Symptoms, Boost Nail Care Reimbursement

Understand difference between G0127 and 11719The HHS Office of Inspector General has warned that Medicare is spending $96.8 million per year on nail debridement and related services that don't have enough documentation to justify payment. The OIG calls for a crackdown in its 2003 Red Book of unimplemented recommendations. Will you be ready? Even old hands can find nail care coding a challenge. To distinguish between G0127 and 11719-21 requires understanding the difference between "systemic conditions" and "sick foot" symptoms. But it can be worthwhile: G0127 reimburses roughly $14 to $26 depending on locality, but CPT 11720...

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