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A wedge excision of the skin of the nail fold is a surgical procedure primarily aimed at treating an ingrown toenail, a condition where the edge of the toenail grows into the surrounding skin, often leading to pain, swelling, and infection. This procedure is particularly indicated for patients experiencing chronic infections that result in diseased tissue along the nail fold. During the wedge excision, a precise incision is made at the nail fold, allowing for the removal of a wedge-shaped section of the affected tissue. This excision helps alleviate the pressure and irritation caused by the ingrown toenail. After the excision, the wound is intentionally left open to heal by secondary intention, which means that the body will naturally close the wound over time without the need for sutures. To promote healing and prevent infection, antibiotic ointment is applied to the area, followed by a protective dressing. This approach not only addresses the immediate issue of the ingrown toenail but also facilitates a more natural healing process for the surrounding skin.
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The wedge excision of the skin of the nail fold is indicated for the following conditions:
The wedge excision procedure involves several key steps that ensure effective treatment of the ingrown toenail.
Post-procedure care involves monitoring the wound for signs of infection and ensuring proper healing. Patients are typically advised to keep the area clean and dry, change the dressing as needed, and apply antibiotic ointment as directed. Follow-up appointments may be scheduled to assess the healing process and address any complications that may arise. Patients should also be informed about signs of infection, such as increased redness, swelling, or discharge, and instructed to seek medical attention if these occur.
| Short Descr | EXCISION OF NAIL FOLD TOE | Medium Descr | WEDGE EXCISION SKIN NAIL FOLD | Long Descr | Wedge excision of skin of nail fold (eg, for ingrown toenail) | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 4 | CCS Clinical Classification | 174 - Other non-OR therapeutic procedures on skin and breast |
| T5 | Right foot, great toe | TA | Left foot, great toe | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | T1 | Left foot, second digit | T6 | Right foot, second digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | T8 | Right foot, fourth digit | LT | Left side (used to identify procedures performed on the left side of the body) | GW | Service not related to the hospice patient's terminal condition | T4 | Left foot, fifth digit | T7 | Right foot, third digit | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | T2 | Left foot, third digit | T3 | Left foot, fourth digit | T9 | Right foot, fifth digit | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | RT | Right side (used to identify procedures performed on the right side of the body) | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | AG | Primary physician | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third digit | F3 | Left hand, fourth digit | F4 | Left hand, fifth digit | F5 | Right hand, thumb | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q5 | Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | Q7 | One class a finding | Q8 | Two class b findings | Q9 | One class b and two class c findings | SG | Ambulatory surgical center (asc) facility service | TR | School-based individualized education program (iep) services provided outside the public school district responsible for the student | UA | Medicaid level of care 10, as defined by each state | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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