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Nail Removal: Best Practices and Documentation

by Glenna Lashley, FNP, MSN

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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

    1. Using correct modifier codes for location, HCPCS codes for supplies, and CPT primary codes for injection and anesthetic
    2. Using only CPT codes for the procedure and supplies
    3. Using ICD-10 codes exclusively for all aspects of the procedure
    4. Using modifier codes only when multiple digits are involved
    5. Using HCPCS codes for both supplies and the primary procedure
    1. Ensure adequate anesthesia is administered and allow sufficient time for full effect
    2. Administer minimum required dose and proceed immediately
    3. Use only local anesthesia regardless of case complexity
    4. Apply anesthesia after initial incision to conserve supplies
    5. Skip anesthesia for minor nail removals
    1. Remove an appropriate portion of the nail matrix to promote proper nail growth
    2. Remove the entire nail matrix in all cases
    3. Leave the nail matrix intact during removal
    4. Remove only the visible portion of the matrix
    5. Skip matrix removal for partial nail procedures
    1. Confirm nail bed clotting and apply a secure bandage that doesn't compromise circulation
    2. Apply tight bandaging to prevent bleeding
    3. Leave the wound open to air dry
    4. Apply minimal dressing to speed healing
    5. Use compression wrapping in all cases

    Author of lecture Nail Removal: Best Practices and Documentation

     Glenna Lashley, FNP, MSN

    Glenna Lashley, FNP, MSN


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