Question: If a diabetic comes with class findings, can I debride 9 nails, leave the nail on the clavus toe alone, pare the clavus on that toe, and report CPT 11721-Q(7,8,9)-59 + CPT 11055-Q(7,8,9)?

Response from Codinghelpline.com:

Yes, that is the correct, provided the documentation clearly establishes that the nail on the clavus distal aspect of the toe was not debrided, and the other Medicare at risk coverage requirements are satisfied. CMS’s 2026 NCCI Policy Manual specifically addresses CPT 11055 (paring/cutting of benign hyperkeratotic lesion) and CPT 11720 (debridement of nail[s], 1–5) or CPT 11721 (debridement of nails 6 and >). CMS states that when the two services are performed on the same distal phalanx, including the skin overlying the DIP joint, modifier 59/XE/XP/XS/XU cannot be used to bypass the edit.

CPT 11055 can be reported for the clavus, assuming all other Medicare coverage/medical-necessity requirements for routine foot care are met. The critical point is that CPT 11720/117211 and CPT 11055 were not both performed on that same distal phalanx or area past the DIPJ. NCCI allows you to bypass the edits with billing but on audit your documentation must demonstrate paring of the hyperkeratosis on that toe and that no nail debridement was done.

The source for 2026-10-1 PTP edits is here and the most current MLN article is here.

—David J Freedman, DPM, CPC, CSFAC, CPMA

Additional coding and billing questions and responses can be found at www.Codinghelpline.com       

About one-third of U.S. physicians have been a defendant or co-defendant in a malpractice lawsuit at some point in their career, according to a new report from Medscape. “Physicians and Malpractice Report 2026,” published Sept. 22, collected data from more than 1,100 full- and part-time physicians across nearly 30 specialties. 

Here are 10 findings from the report:

Source: Medical Economics

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Were you impacted by an exceptional residency program director?
Nominations are now open for the COTH Program Director of the Year Award! Help recognize an outstanding teacher, mentor, and leader who has made a lasting impact on the next generation of podiatric physicians. Nominate someone deserving today!

Source: ABPM

You are selling your practice. You may or may not be retiring or relocating. The time to think about the things you need to do is months prior to the sale. You will want to work with an experienced healthcare attorney. A real estate attorney or a corporate attorney will not do, as there are unique considerations in a clinical practice that do not apply to other types of sales. This article is not intended to cover every aspect of closing or selling a podiatric practice.

For many podiatrists, orthotic therapy can be a frustrating and challenging part of practice. In this lecture, Dr. Jarrod Shapiro discusses causes of these frustrations and focuses on methods to improve the success of this part of practice with an aim to improve profitability and satisfaction for both patients and physicians.

Source: Present Podiatry

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Here’s a business model I’d never have believed if I hadn’t read the contract. Medicare hires a private tech company to review whether your procedure should be covered. The company uses artificial intelligence to help decide. And the company gets paid a cut of the money Medicare doesn’t spend. Say no, get paid. Say yes, get nothing.

Source: Money Talks News

Physicians navigating today's job market are seeing a compensation landscape that looks stable on the surface but has shifted underneath. Resolve's 2026 Physician Salary & Employment Report shows base salary growth cooling to 2.9–3.7 percent nationally, down from the 5–6 percent pace of the post-pandemic years. But employers haven't pulled back on total compensation—they've restructured it. 

Source: Resolve

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Full-Time Chair—Department of Podiatric Medicine & Surgery

The Dr. William M. Scholl College of Podiatric Medicine is seeking a full-time chair for the Department of Podiatric Medicine & Surgery. The chair will lead faculty, drive academic excellence, and oversee clinical experiences in a collaborative environment. Generous benefits! ($120K–$140K)

Contact:[email protected] or apply at https://www.rosalindfranklin.edu/employment/

Practice seeks associate in Connecticut. Owner will stay for transition. Full privileges available. Fax resume to 203-729-9046.

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