tci E/M Coding Alert - 2014 Issue 9

Reader Question: Prove Medical Necessity for 11721 with 99213

Question: Can I bill Medicare for an E/M visit (99213) along with a debridement of nails (11721)? Arkansas Subscriber Answer: Yes, as long as the documentation clearly illustrates that the nail debridement is determined to be necessary at this visit and that the office visit is separately identifiable.  If so, you will report the nail debridement with code 11721 (Debridement of nail[s] by any method[s]; 6 or more) and the office visit with the 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key...

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