CPT® Code 11752

Deleted

1. Indications

The procedure described by CPT® Code 11752 is indicated for the following conditions:

• Chronic Ingrown Toenails - This condition occurs when the edges of the toenail grow into the surrounding skin, causing pain, inflammation, and potential infection.
• Deformed Nails - Nails that are malformed due to injury or disease may require excision to alleviate discomfort and prevent further complications.
• Sunken Nails - Nails that have become sunken or embedded in the surrounding tissue may necessitate removal to restore normal nail function and appearance.

2. Procedure

The procedure for CPT® Code 11752 involves several detailed steps to ensure effective excision and matrix destruction:

• Partial Excision - The procedure begins with the partial excision of the nail, where the lateral aspects of the nail are excised. A nail elevator is inserted under the distal edge of the nail to free the nail plate from the lateral edge. The new lateral edge is identified, and a nail splitter is used to cut the nail straight back to the most proximal edge under the nail fold.
• Removal of Nail Fragment - Once the lateral piece of the nail is severed, it is grasped with a hemostat. The fragment is then rotated outward toward the lateral nail fold and pulled straight out toward the end of the toe, ensuring complete removal of the nail portion.
• Destruction of Nail Matrix - The nail matrix is destroyed using a flat matricectomy electrode, which is placed below the nail fold just above the nail bed. Cautery is applied to the matrix and the entire exposed nail bed to prevent regrowth. Any granulation tissue present is also destroyed by electrocautery. This process may be repeated on the opposite side of the nail as necessary.
• Complete Excision - In cases requiring complete excision, the entire nail is removed, and the entire matrix is ablated with electrocautery, following similar steps as the partial excision.
• Amputation of Distal Phalanx - If amputation of the tuft of the distal phalanx is indicated, an incision is made at the distal aspect of the toe. Tissue is dissected to expose the distal phalanx, which is then amputated, and the distal phalanx is remodeled to restore proper anatomy.

3. Post-Procedure

After the procedure, antibiotic ointment is applied to the surgical site, followed by a dressing to protect the area. Patients are typically advised on post-operative care, which may include keeping the area clean and dry, monitoring for signs of infection, and managing pain as needed. Recovery time may vary depending on the extent of the procedure performed, particularly if distal phalanx amputation was necessary. Follow-up appointments may be scheduled to assess healing and ensure proper recovery.