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Nail Removal: Best Practices and Documentation
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Slides Nail-Removal-Best-Practices-and-Documentation.pdf
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00:01 Let's start with some summary statements. 00:03 Coding involves similar considerations to any other procedure using anesthesia. 00:08 Make sure you're using the correct modifier codes for the specific location codes for all the supplies use. CPT primary codes for the injection and the anesthetic used. 00:22 You also would want to note if you did multiple digit blocks as well. 00:27 ICD10 diagnosis codes are specific for the procedure, particularly the digital block. 00:33 And so you'll need to make sure that you're using the correct anatomical location and relevant pain codes. I've seen some mistakes in practice. 00:42 Ensure adequate anesthesia is administered and allow sufficient time for it to take full effect. Gently lifting the nail with care to protect the nail bed and minimize the risk of damage. Remove an appropriate portion of the nail matrix to promote proper nail growth. 00:59 Confirm that the nail bed has clotted effectively before applying the dressing, and apply the bandage securely yet comfortably, ensuring it doesn't compromise circulation. 01:10 Toenail removal is a skill that seems different every time I do it. 01:15 I think it's because everyone's toes are a little different. 01:19 Another thing to think about is make sure you're always in a comfortable position as well, when you get ready to do a procedure. 01:26 Thank you for watching.
About the Lecture
The lecture Nail Removal: Best Practices and Documentation by Glenna Lashley, FNP, MSN is from the course Removal Procedures in Primary Care.
Included Quiz Questions
Which of the following best describes the key coding considerations for toenail removal procedures?
- Using correct modifier codes for location, HCPCS codes for supplies, and CPT primary codes for injection and anesthetic
- Using only CPT codes for the procedure and supplies
- Using ICD-10 codes exclusively for all aspects of the procedure
- Using modifier codes only when multiple digits are involved
- Using HCPCS codes for both supplies and the primary procedure
What are the key considerations for administering anesthesia during a toenail removal procedure?
- Alllow at least 5-10 minutes for anesthesia to take effect, and check the sensation in the affected area
- Administer minimum required dose and proceed immediately to take advantage of the immediate anesthetic effect
- Topical anesthesia is the first option for toenail removal procedures.
- Anesthesia or nerve block can be skipped for toenail removal procedure in most patients.
Which statement best describes the proper technique for nail matrix removal?
- Remove an appropriate portion of the nail matrix to promote proper nail growth
- Remove the entire nail matrix ito prevent nail deformities
- Leave the nail matrix intact during removal of the toenail
- Remove only the visible portion of the matrix
- Matrix removal is contraindicated in toenail removal procedures for ingrown toenail
What is the correct approach to post-procedure care in toenail removal?
- Confirm nail bed clotting and apply a secure bandage that does not compromise circulation
- Apply compressive bandaging to the toe to prevent bleeding
- It is best to leave the wound open to air dry to promote healing and nail growth
- Povidone-iodine application twice a day after the procedure limits bleeding and promotes nail growth
Author of lecture Nail Removal: Best Practices and Documentation
Glenna Lashley, FNP, MSN
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