“My business partner and I have different opinions regarding this issue and I’m having trouble finding a succinct and primary source document. When performing nail care and callus care for a high-risk patient, can you bill for both when the callus is located on the tip of the toe? It is my understanding that the skin is a separate structure than the nail and thus they are separate diagnoses and CPT codes, but my business partner states he heard a lecture that stated not to charge for calluses that occur on the same toe as a nail that is trimmed or debrided. This seems to be an LCD-dependent decision as I have not been able to locate anything in CMS policy that states either way. Can someone point us in the right direction with primary source reference?”
by Alivia Leatherman, Registry Clearinghouse Support
October 14, 2025
By justina
0 Comments
Description:
Measure 47 Advance Care Plan measures the percentage of patients aged 65 years and older who YOU HAVE ASKED if they have an advance care plan or surrogate decision maker. The discussion must be documented in the patients medical record. The patient having an advance care plan is not required, only that it be discussed during the visit.
“I have a patient with a nonhealing pressure wound on his right ankle and his right heel. I applied a skin graft substitute to both sites. I used a single piece and shared it between the two sites. The ICD-10 code I used for the ankle is L89.513. The ICD 10 code I used for the heel is L89.613. For the application codes I utilized CPT code 15271-RT for L89.513 and CPT code 15275-RT for L89.613. The NCCI Edits does not show any conflict, but I am wondering whether a -51 is necessary. I also used the correct Q code for the product.”