Medicare Denials for Debridement of Nails

Medicare recently announced that their system incorrectly denied claims relating to debridement of nails proce- dures and other routine foot care. We have seen these denials for codes 11720 and 11721 come over as “PR-50” (not medically necessary). Per Medicare, this is an internal issue related to ICD-10 coding updates. They are currently working to reprocess and pay all affected claims, and have stated that no provider action is necessary.

Medicare stated they are adding new diagnoses to the coverage determination for routine foot care, but these changes have not been published or taken effect yet. Continue to code these charges the same as you have previously.

Brandon McCurdy