Overview of CPT Code 11765:Removal of nail plate, partial

Overview of CPT Code 11765:Removal of nail plate, partial

CPT Code 11765 refers to the surgical procedure for the partial removal of a nail plate. This procedure is typically performed to address conditions affecting the nail, such as ingrown toenails or nail infections, where only a portion of the nail needs to be excised.

When CPT Code 11765 is Used?

This procedure is indicated in various clinical scenarios.

• Ingrown toenails causing pain and inflammation.
• Nail plate infections that do not respond to conservative treatment.
• Nail dystrophies where partial removal is necessary for diagnosis or treatment.
• Trauma to the nail that requires partial excision for healing.

Symptoms Indicating This Procedure

Patients may present with several symptoms that warrant this procedure.

• Localized pain around the nail bed.
• Swelling and redness in the affected area.
• Discharge or pus from the nail fold.
• Difficulty wearing shoes or walking due to discomfort.

Causes and Risk Factors

Understanding the underlying causes can help in prevention.

• Improper nail trimming techniques leading to ingrown nails.
• Genetic predisposition to nail disorders.
• Footwear that does not fit properly.
• Previous trauma to the nail or nail bed.

Diagnostic Tests Before Procedure

Certain tests may be conducted to confirm the need for the procedure.

• Physical examination of the affected nail and surrounding tissue.
• Nail cultures to identify any underlying infections.
• X-rays if trauma is suspected to assess for bone involvement.

Procedure Description

The procedure is performed under sterile conditions.

• The patient is positioned comfortably, and the affected area is cleaned.
• Local anesthesia is administered to numb the area.
• A tourniquet may be applied to minimize bleeding.
• The surgeon carefully lifts the nail plate and excises the affected portion.
• The area is cleaned, and a dressing is applied.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid taking blood-thinning medications prior to the procedure.
• Inform the physician of any allergies, especially to anesthetics.
• Wear comfortable clothing and shoes to the appointment.
• Arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure care is crucial for optimal recovery.

• Rest and elevate the foot to reduce swelling.
• Keep the area clean and dry, changing dressings as instructed.
• Take prescribed pain medications as needed.
• Avoid tight footwear until fully healed.

Possible Complications

While generally safe, there are potential risks involved.

• Infection at the surgical site.
• Excessive bleeding during or after the procedure.
• Nail regrowth issues or deformities.
• Persistent pain or discomfort in the area.

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Post-Procedure Follow-Up

Follow-up appointments are essential for monitoring recovery.

• Schedule a follow-up visit within 1-2 weeks post-procedure.
• Monitor for signs of infection or complications.
• Discuss any concerns regarding pain or healing with the physician.

Alternative Treatments

There are non-surgical options available for some conditions.

• Topical antifungal or antibiotic treatments for infections.
• Orthotic devices to relieve pressure on the nail.
• Regular nail care and proper trimming techniques.

Home Care Tips

Patients can take steps at home to aid recovery.

• Keep the foot elevated to reduce swelling.
• Avoid soaking the foot in water until the area is healed.
• Wear open-toed shoes to minimize pressure on the toe.
• Monitor the site for any changes or signs of infection.

Patient Education & Prevention

Educating patients can help prevent recurrence.

• Practice proper nail trimming techniques.
• Wear well-fitting shoes to avoid pressure on the nails.
• Seek early treatment for any nail infections or abnormalities.
• Maintain foot hygiene to prevent fungal infections.

Billing and Coding Information

CPT Code: 11765

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• 59 - Distinct procedural service

Average Cost and Insurance Coverage

Costs can vary based on location and insurance.

• Average cost ranges from $200 to $600.
• Most insurance plans cover the procedure if deemed medically necessary.
• Patients should verify coverage with their insurance provider.

Related CPT Codes

• 11730 - Removal of nail, partial or complete, any nail
• 11732 - Paring or cutting of hyperkeratotic skin (e.g., callus, corn) on toes
• 11740 - Debridement of nail, partial or complete
• 11750 - Excision of nail and nail matrix
• 11760 - Removal of nail, partial or complete

References and Sources

• American Academy of Dermatology
• American Podiatric Medical Association
• Mayo Clinic - Ingrown Toenails