If I grind toenails what is the correct way to code them?

This is a great question as it depends if it is a private insurance or Medicare or an insurance that follows Medicare. Technically, CPT 11720 and 11721 are your codes for nail debridement, but most Medicare billing policies require these 2 CPT codes to be billed for onychomycosis with pain or limitation of ambulation, which this author feels should not be as frequently billed as at-risk foot care. Depending on the Medicare MAC, some just require the at risk systemic ICD10 diagnosis, as an example, PVD or Diabetes with PAD without the onychomycosis diagnosis but some Medicare MACs require the 2 diagnoses, so it is incumbent on you to look at your Medicare payer to see their billing rules. If billing Medicare for dystrophic nails and all you are doing is trimming them, then use HCPCS Code G0127. If the private insurance does not have a "follows Medicare rule" then use either CPT 11720 or 11721 for your nail debridement. The key with this procedure or any procedure, please make sure you document each nail in the exam and then in the procedure note, make sure you document which nails are debrided and with what instrumentation that you used.