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Toenail excision

What is the proper documentation that needs to be done by the provider to be able to charge 11750 excision of nail and nail matrix partial or complete, for permanent removal?
As my provider has a template that he follows for example:

consent was signed: yes
complications discussed: yes
timed out procedure was observed: yes
Anesthesia: Lidocaine 1% lidocaine digital nerve block
Ingrown nail elevated and excised back to the nail matix: yes (using hemostat)
Excess granulation tissue debride:yes
Treated with phenol: no
Hemostasis assured: no
Blood loss: none
Complications: none

Let me know what you think or what else I should ask the provider to include in his notes as these to me seem very minimal.
Thanks

Medical Billing and Coding Forum

Ingrown Toenail Medical Procedures and Contaminated Toenail Treatment

For many people, ingrown toenail surgical treatment will be the proposed solution, with home treatments fantastic for easing the signs or symptoms and agony, but almost never beneficial as a protracted term cure solution. Ingrown toenails often form on account of an abnormality in the anatomy of your toe and nail, an ailment which is commonly inherited. The anatomy from the toe as well as the nailbed makes ingrown toenails all but a certainty for some men and women, with short name treatments easing the problem but hardly ever correcting the situation for very long.

In these kinds of situations, surgical treatment is expected to take away the offending element with the nail to discontinue it from expanding in to the pores and skin. A sliver with the nail is taken off, operating in the tip towards the base. This straight away eases the strain around the pores and skin, and will cease soreness and swelling. Even so as a way to make sure that the ailment does not return, element from the nailbed by itself is destroyed. The destruction is usually accomplished by chemical means, with phenol considered one of the most common agents utilised. Using the nailbed partially destroyed, the ingrown toenail is unlikely to return.

Nonetheless even this remedy may possibly not be ample, with repeat procedures necessary periodically for some men and women. In these kinds of circumstances quite a few look for much more drastic surgical intervention. A technique dating back again to 1959 targets the toe by itself, in lieu of the toenail. The Vandenbos technique just isn’t frequently carried out, with only a couple of United States surgeons conducting the really invasive and destructive technique. The nail is left entirely untouched, even so aspect in the toe is taken out on every facet with the nail. While the toenail will look intact and excellent, the method removes a substantial total of tissue, which may take on some weeks to heal and may be extremely uncomfortable.

The technique has been shown to be extremely efficient; nevertheless the invasive nature has arrive below appreciable criticism for leaving the toe open to serious infection. More than 600 patients have benefitted through the cure with none recurrence; even so the technique appears a tiny barbaric, and will take on significantly lengthier to get a complete restoration than a straightforward chemical cauterization from the nail matrix.
Nonetheless such will be the discomfort suffered, that it leads people to require all manner of drastic measures to ease the pain and struggling. Even so ahead of these types of a course of action is used, it is a smart move to decide for the chemical treatment method in the primary instance, and only if that fails, undertake much more drastic measures.

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