Summary & Overview
CPT 11752: Nail and Nail Matrix Excision with Distal Phalanx Tuft Amputation
CPT 11752 described a dermatologic surgical procedure for permanent removal of a nail and nail matrix with amputation of the distal phalanx tuft. Although the code was deleted effective January 1, 2017, its clinical scope remains relevant for documentation, historical billing review, and transition to revised coding practices nationally. The code pertained to definitive surgical management of severe nail disorders when partial or complete matrix excision and distal phalanx tuft amputation were performed.
This publication covers national implications for coverage and coding transitions, with payers addressed including Blue Cross Blue Shield and Cigna Health. Readers will find a concise explanation of the code's clinical intent and typical site of service, plus guidance on common billing modifiers and related coding references for historical crosswalks. The content summarizes applicable diagnosis contexts for the procedure and notes professional taxonomies commonly associated with clinicians who performed it.
The report helps billing managers, coding professionals, and clinical administrators understand the code's purpose, the payer environment in which it historically appeared, and where to look for related codes and documentation considerations. Data not provided in the input are explicitly flagged where applicable.
CPT Code Overview
CPT 11752 was a dermatologic surgical code for the excision of the nail and nail matrix, partial or complete, with amputation of the tuft of the distal phalanx for permanent nail removal. The description indicates use for conditions such as ingrown or deformed nails requiring definitive surgical removal of the nail unit and distal phalanx tuft.
Service Type: Dermatology
Typical Site of Service: Office (POS 11)
Data not available in the input regarding service line details beyond the fields listed above.
Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to a dermatology office with a chronically painful, recurrent ingrown toenail unresponsive to conservative measures (soaks, topical agents, partial nail avulsion). Examination reveals nail deformity and involvement of the nail matrix with recurrent granulation tissue and infection. The clinician counsels that permanent removal of the nail and matrix with amputation of the tuft of the distal phalanx may be necessary for definitive management. The procedure is scheduled in the office (POS 11) under local anesthesia. Typical workflow: pre-procedure consent and medical history review, sterile preparation, local anesthesia, excision of nail and nail matrix with amputation of the tuft of the distal phalanx, hemostasis and dressing, post-procedure instructions, and short-term follow-up for wound check and dressing change.
Coding Specifications
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Common Modifiers
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51: Use when multiple procedures are performed during the same encounter and the payer requires reporting of multiple procedures; applies when this procedure is billed in addition to another primary procedure. -
59: Use to indicate a distinct procedural service that is separate and independent from other services performed on the same day; applies when documentation supports a separate anatomic site or separate session/procedure. -
Provider Taxonomies and Specialties
| Taxonomy Code | Specialty |
|---|---|
207N00000X | Dermatology Physician |
213ES0103X | Podiatrist |
207Q00000X | Family Medicine Physician |
Related Diagnoses
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L60.0— Ingrowing nailClinical relevance: Ingrowing nail causes localized pain, inflammation, and recurrent infection that may necessitate partial or complete nail and matrix excision with possible amputation of the distal tuft for definitive treatment.
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L60.1— OnycholysisClinical relevance: Separation of the nail plate from the nail bed can contribute to chronic nail deformity and recurrent pathology; when severe or refractory, matrix and nail excision may be considered.
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L60.2— OnychogryphosisClinical relevance: Thickened, curved (ram’s horn) nails can cause functional impairment and recurrent soft tissue injury; surgical nail and matrix removal with tuft amputation may be part of definitive management.
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L60.3— Nail dystrophyClinical relevance: Structural abnormalities of the nail apparatus that are symptomatic or recurrent can indicate need for excision of the nail and matrix.
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L60.4— Beau's linesClinical relevance: Transverse depressions of the nail reflect prior growth disturbance; if associated with persistent deformity or recurrent complications, surgical intervention on the nail unit may be considered.
Related CPT Codes
| CPT Code | Description |
|---|---|
11750 | Phalanx tuft amputation (deleted code related revision) |
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11750is a deleted code related to phalanx tuft amputation and is clinically related as it denotes removal of a distal phalanx tuft, which overlaps with the described amputation component of the deleted11752procedure. -
11750may be used historically in documentation or coding audits but is not an active current code for billing; it is an alternative reference when reviewing prior records or code revisions.
National Reimbursement Benchmarks
Across the national benchmarks for CPT 11752, BUCA (representing average commercial) posts a higher mean rate than Medicare; specific Medicare mean rate data is not available in the input while BUCA's mean is $610.74. Blue Cross Blue Shield's mean rate of $565.79 falls below BUCA's national commercial average, and Cigna's mean of $636.41 is above both BCBS and BUCA.
Rate dispersion varies by payer where data is available. Cigna shows the widest interquartile spread with a P75–P25 difference of $316.50 ($836.50 − $520.00), indicating greater variability. Blue Cross Blue Shield has a wide spread as well at $316.17 ($734.67 − $418.50). BUCA's spread is narrower than Cigna and BCBS at $326.81 ($757.61 − $430.80) when rounded; however, note that some payers have no data in the input. The table and chart below present the full breakdown.
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