ANSWER: My first recommendation is to know what CMS says, take a look at this link Foot care (routine) | Medicare If all the provider is doing is nail debridement, then they should be billing the nail CPT codes (11720 & 11721) regardless of traditional Medicare rules. If the MA plan has the policy they cover non medically necessary nail care, then if you perform that service, you should bill the most appropriate CPT coding that day.
ANSWER: My first recommendation is to know what CMS says, take a look at this link Foot care (routine) | Medicare If all the provider is doing is nail debridement, then they should be billing the nail CPT codes (11720 & 11721) regardless of traditional Medicare rules. If the MA plan has the policy they cover non medically necessary nail care, then if you perform that service, you should bill the most appropriate CPT coding that day.