removal of ingrown toenail cpt codeblack and white emoji aesthetic

Copyright © 2022, the American Hospital Association, Chicago, Illinois. %PDF-1.5 % If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary. Applicable FARS/HHSARS apply. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". End User License Agreement: LCD - Surgical Treatment of Nails (L33833) - Centers for Medicare There is no preparation of this material, or the analysis of information provided in the material. hb```b``fa`e``db@ !+A6 "TaWYX+3*:+[02z-v 3t/pu0r2X2``8'\@Tw$X3Cg^-rtr_s|gvN/X|gN!v~K9c!FBKRv3!YI\w|g"kgvQR;U`iDA`OYj%}u\L_@ ;g4gx(T"Q\:..U,Cu)7K;7X;r0b20(w $n-^$!d^$!u\H: 7[LerFd/ d2 ( #b+i~3Z2We \81g/Aq493Ed5@/fg`0gL_U L When CPT code 11730, 11732 or 11750 is reported, it represents all services performed on that nail for that date of service (DOS). The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book. Wedge excision of the nail fold hypertrophic granulation tissue with removal of the offending portion of the nail (CPT code 11765). Revenue Codes are equally subject to this coverage determination. Instructions for enabling "JavaScript" can be found here. CPT 91311, 0111A, 0112A Covid Vaccine for children, 5 Important points to improve claim submission success rate. The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. When billing for non-covered services, use the appropriate modifier. A medically reasonable and necessary repeat avulsion or excision of the same nail within 32 weeks of a previous avulsion, or excision, of the same nail, will be considered upon redetermination. A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833 (e) of the Social Security Act. recommending their use. BCBS prefix Why its important to read correctly. Apr 18, 2014. L27532 - Surgical Treatment of Nails CMS and its products and services are not endorsed by the AHA or any of its affiliates. Please visit the, Chapter 23, Section 20.9 National Correct Coding Initiative (CCI), Chapter 1, General Correct Coding Policies for National Correct Coding Initiative Policy Manual for Medicare Services, Chapter 3, Surgery: Integumentary System CPT codes 10000-19999 For National Correct Coding Initiative Policy Manual for Medicare Services. DISCLOSED HEREIN. Listing of a code in this guideline does not imply that the service described by the code is a covered or non-covered health service. How to Code Nail Procedures - ACEP Now Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Routine foot care is covered only when certain systemic conditions are present. that coverage is not influenced by Bill Type and the article should be assumed to Other conditions may also require avulsion of part or all of a nail. CPT codes, descriptions and other data only are copyright 2022 American Medical Association. This LCD describes conditions under which the coverage of nail avulsion/excision may be considered. Modifier 53 Required fields are marked *. an effective method to share Articles that Medicare contractors develop. I agree with Kristie this is what I use as well. Permanent correction of recurring ingrown toenail by nail resection or wedge excision of the nail lip should be billed with CPT code 11750 or 11765 and not as an incision Question: Are there different codes for managing nail problems? If you would like to extend your session, you may select the Continue Button. You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. Wedge excision of the nail fold hypertrophic granulation tissue with removal of the offending portion of the nail (CPT procedure code 11765). All the articles are getting from various resources. Neither the United States Government nor its employees represent that use of such information, product, or processes Ingrown Toenail Surgery: Procedure and Aftercare - Healthline hbbd```b``Y"H^0[~ CPT code 26011, Drainage of finger abscess; complicated (eg, felon) should be reported with more complicated abscesses or a felon, which require debridement or irrigation for treatment. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. It may not display this or other websites correctly. Z codes represent reasons for encounters. of every MCD page. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not WebHow do you properly code bilateral hallux nail avulsions? When damage to the nail is extensive and removal is required, report it with CPT code 11730 (avulsion of nail plate, partial or complete, simple, single, 1.58 RVUs, Please enable "JavaScript" and revisit this page or proceed with browsing CMS.gov with However, in the case of a chronic condition, a more aggressive action may be necessary such as a chemical or laser procedure that removes the corner of the iniquitous nail and its matrix. 44207 What modifier is used to report the termination of a surgery following induction of anesthesia due to extenuating circumstances or those that threaten the well-being of the patient? The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Absence of a Bill Type does not guarantee that the will not infringe on privately owned rights. Article revised and published on 01/12/2017 effective for dates of service on and after 01/01/2017 to reflect the annual CPT/HCPCS code updates. National Correct Coding Initiative (NCCI) Citation: Social Security Act (Title XVIII) Standard References: This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L34887 Surgical Treatment of Nails. endstream endobj 847 0 obj <>/Metadata 75 0 R/OCProperties<>/OCGs[875 0 R]>>/Outlines 84 0 R/PageLayout/SinglePage/Pages 839 0 R/StructTreeRoot 139 0 R/Type/Catalog>> endobj 848 0 obj <>/ExtGState<>/Font<>/Pattern<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 849 0 obj <>stream For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. WebThe amputation code you used is not stated, but for a toe there are two CPT codes: 1) CPT 28820-Amputation, toe; metatarsophalangeal joint. Complicated wounds of the toes involving nail components. without the written consent of the AHA. of the Medicare program. ,lEPnL^aB8. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Wedge excision of skin of nail fold (CPT code 11765) is designed to relieve pressure on the nail/soft Instructions for enabling "JavaScript" can be found here. presented in the material do not necessarily represent the views of the AHA. E&M working up the patient for this initial encounter for a new problem requiring a procedure. descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work JavaScript is disabled. I am having trouble deciding on which code to use for the removal of an ingrown toenail in an ambulatory outpatient setting. The Medicare program provides limited benefits for outpatient prescription drugs. Podiatry Management Medicare expects that patients will not routinely require the maximum allowable number of services. CPT code information is copyright by This page displays your requested Article. These materials contain Current Dental Terminology (CDTTM), copyright© 2022 American Dental Association (ADA). Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, Medicare revalidation process how often provide need to do FAQ, Step by step Guide Medicare participation program. Medicare is establishing the following limited coverage for. End User Point and Click Amendment: The revenue codes and UB-04 codes are the IP of the American Hospital Association. 874 0 obj <>/Filter/FlateDecode/ID[<12499A3DA2267343BAF3419DBB56A67A><37D24C6FEB3B8D4C9E5523061C2DFCBD>]/Index[846 62]/Info 845 0 R/Length 117/Prev 959505/Root 847 0 R/Size 908/Type/XRef/W[1 3 1]>>stream Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. This procedure involves the separation and removal of a border of the nail or removal of the entire nail from the nail bed to the eponychium. The 2023 edition of ICD-10-CM L60.0 became Search Page 1/20: toenail removal - ICD10Data.com The following ICD-10-CM codes support medical necessity and provide coverage for CPT codes: 11730, 11732, 11750, and 11765: * Note: Report standalone ICD-10-CM code L60.8 for the indication of subungual abscess, subungual tumor, periungual tumor, subungual hematoma, or melanoma. Use 11730 for 'Avulsion' of the ingrown nail and nail plate for temporary removal. Using modifier 50 to the second removal tells the insurer that the podiatrist carries out the toe removal as bilateral procedure. Injuries may include contusions, nail damage, and nail bed lacerations. The op report states that the nail matrix was destroyed by "phenol and alcohol for permanent removal due to ingrown accessory nail". Coding The submitted CPT/HCPCS code must describe the service performed. Therefore, a partial or complete excision of nail and nail matrix may be the preferred course of treatment for recurrent ingrown nails. Medicare requires the medical necessity for each service reported to be clearly demonstrated in the patients medical record. ICD-10-CM Diagnosis Code We have billed the procedures several ways, and have been getting denials recently. The views and/or positions Medicare contractors are required to develop and disseminate Articles. Reporting CPT code 11750 (excision) with CPT code 11765 (wedge resection) for the same digit on the same DOS is not correct coding.CPT code 11765 requires an excision of a wedge of the skin of the nail fold from the involved side of the toe. Article revised and published on 06/02/2022 effective for dates of service on and after 06/06/2022. (Refer to LCD: Routine Foot Care). Chapter 12 Diseases of the Skin and Subcutaneous Tissue Code expansions: Updates to medical terminology. Applicable FARS\DFARS Restrictions Apply to Government Use. All rights reserved. CPT is a trademark of the American Medical Association (AMA). However, services performed for any given diagnosis must meet all of the indications and limitations stated in this policy, the general requirements for medical necessity as stated in CMS payment policy manuals, any and all existing CMS national coverage determinations, and all Medicare payment rules. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. If a nail bed injury requires repair, report it with 11760 (repair of nail bed, 3.27 RVUs, Medicare $117.84). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. Treatment of simple uncomplicated or asymptomatic ingrowing nail by removal of the offending nail spicule not requiring local anesthesia is considered to be routine foot care as are other trimming, cutting, clipping and debriding of a nail distal to the eponychium. Article revised and published on 07/16/2015 to include reference to the Routine Foot Care LCD and Article, to include modifiers for the fingers and to provide direction regarding proper billing of CPT code, Some older versions have been archived. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. I am leaning towards an unlisted code rather than CPT 11750 since CPT 11750 references surgical No fee schedules, basic unit, relative values or related listings are included in CPT. Procedure code 11730 (Avulsion of nail For the following CPT/HCPCS code either the short description and/or the long description was changed. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Reproduced with permission. Billing and Coding: Routine Foot Care and Debridement of Nails CPT Coding for Ingrown Toenails - AQuity Solutions Nail avulsions usually offer only temporary relief for ingrown toenails. Complicated wounds of the toes involving nail components. GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES Could someone please help? required field. Also, you can decide how often you want to get updates. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. When lateral and medial sides of a nail are involved, do not report a separate code for each border.Procedure code 11750 (Excision of nail and nail matrix, partial or complete, [e.g., ingrown or deformed nail] for permanent removal) requires the removal of the full length or the entire nail plate, with destruction or permanent removal of the matrix by any means.Reporting CPT codes 11730 or 11732 (avulsion) with CPT code 11750 (excision) and or 11765 (wedge resection) for the same digit on the same DOS is not correct coding. "et|+D+CDuM@9 Jad(v f-n,Q@w5t Coding an Evaluation and Management with a An ingrown nail is growth of the nail edge into the surrounding soft tissue that may result in pain, inflammation or infection. )+H PfA $AAL3P;TJ1-P$.{qi6K~q*i>8/qq(ecT~coM1e[_MQf9CH&=*?q!1?ie\|73gLbm}k]|'EbZu;;!Wqc/8q1 4 I#)U?jq"m_jQ2E%&AqjtMo~vs_-.j[%Trj7-s,JK.wZ2'S%"__. which insurance is primary. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. This email will be sent from you to the complete information, CMS does not guarantee that there are no errors in the information displayed on this web site. Reporting CPT code 11765 for the removal of a small piece of the skin and/or the nail without local anesthesia is not correct coding.Procedure code 11730 (Avulsion of nail plate, partial or complete, simple; single) is reported when removing part of the nail plate or the entire nail plate. B. Single-center to How to Code Nail Procedures, Your email address will not be published. All Rights Reserved (or such other date of publication of CPT). Self-Administered Drug (SAD) Exclusion List articles list the CPT/HCPCS codes that are excluded from coverage under this category. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. A nail avulsion usually requires injected local anesthesia except in instances wherein the digit is devoid of sensation or there are other extenuating circumstances for which injectable anesthesia is not required or is medically contraindicated. "JavaScript" disabled. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims. Routine Foot Care - Medical Clinical Policy Bulletins | Aetna CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug. Method of obtaining anesthesia (if not used, the reason for not using it). Other conditions may also require avulsion of part or all of a nail. CMS and its products and services are At least as beneficial as an existing and available medically appropriate alternative. used to report this service. All documentation must be maintained in the patient's medical record and made available to the contractor upon request. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, A58961 - Response to Comments: Surgical Treatment of Nails, Contusion of right thumb with damage to nail, initial encounter, Contusion of right thumb with damage to nail, subsequent encounter, Contusion of right thumb with damage to nail, sequela, Contusion of left thumb with damage to nail, initial encounter, Contusion of left thumb with damage to nail, subsequent encounter, Contusion of left thumb with damage to nail, sequela, Contusion of right index finger with damage to nail, initial encounter, Contusion of right index finger with damage to nail, subsequent encounter, Contusion of right index finger with damage to nail, sequela, Contusion of left index finger with damage to nail, initial encounter, Contusion of left index finger with damage to nail, subsequent encounter, Contusion of left 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nail, subsequent encounter, Laceration without foreign body of left great toe with damage to nail, sequela, Laceration without foreign body of right lesser toe(s) with damage to nail, initial encounter, Laceration without foreign body of right lesser toe(s) with damage to nail, subsequent encounter, Laceration without foreign body of right lesser toe(s) with damage to nail, sequela, Laceration without foreign body of left lesser toe(s) with damage to nail, initial encounter, Laceration without foreign body of left lesser toe(s) with damage to nail, subsequent encounter, Laceration without foreign body of left lesser toe(s) with damage to nail, sequela, Laceration with foreign body of right great toe with damage to nail, initial encounter, Laceration with foreign body of right great toe with damage to nail, subsequent encounter, Laceration with foreign body of right great toe with damage to nail, sequela, Laceration with foreign body of left great toe with damage to nail, initial encounter, Laceration with foreign body of left great toe with damage to nail, subsequent encounter, Laceration with foreign body of left great toe with damage to nail, sequela, Laceration with foreign body of right lesser toe(s) with damage to nail, initial encounter, Laceration with foreign body of right lesser toe(s) with damage to nail, subsequent encounter, Laceration with foreign body of right lesser toe(s) with damage to nail, sequela, Laceration with foreign body of left lesser toe(s) with damage to nail, initial encounter, Laceration with foreign body of left lesser toe(s) with damage to nail, subsequent encounter, Laceration with foreign body of left lesser toe(s) with damage to nail, sequela, Puncture wound without foreign body of right great toe with damage to nail, initial encounter, Puncture wound without foreign body of right great toe with damage to nail, subsequent encounter, Puncture wound without foreign body of right great toe with damage to nail, sequela, Puncture wound without foreign body of left great toe with damage to nail, initial encounter, Puncture wound without foreign body of left great toe with damage to nail, subsequent encounter, Puncture wound without foreign body of left great toe with damage to nail, sequela, Puncture wound without foreign body of right lesser toe(s) with damage to nail, initial encounter, Puncture wound without foreign body of right lesser toe(s) with damage to nail, subsequent encounter, Puncture wound without foreign body of right lesser toe(s) with damage to nail, sequela, Puncture wound without foreign body of left lesser toe(s) with damage to nail, initial encounter, Puncture wound without foreign body of left lesser toe(s) with damage to nail, subsequent encounter, Puncture wound without foreign body of left lesser toe(s) with damage to nail, sequela, Puncture wound with foreign body of right great toe with damage to nail, initial encounter, Puncture wound with foreign body of right great toe with damage to nail, subsequent encounter, Puncture wound with foreign body of right great toe with damage to nail, sequela, Puncture wound with foreign body of left great toe with damage to nail, initial encounter, Puncture wound with foreign body of left great toe with damage to nail, subsequent encounter, Puncture wound with foreign body of left great toe with damage to nail, sequela, Puncture wound with foreign body of right lesser toe(s) with damage to nail, initial encounter, Puncture wound with foreign body of right lesser toe(s) with damage to nail, subsequent encounter, Puncture wound with foreign body of right lesser toe(s) with damage to nail, sequela, Puncture wound with foreign body of left lesser toe(s) with damage to nail, initial encounter, Puncture wound with foreign body of left lesser toe(s) with damage to nail, subsequent encounter, Puncture wound with foreign body of left lesser toe(s) with damage to nail, sequela, Open bite of right great toe with damage to nail, initial encounter, Open bite of right great toe with damage to nail, subsequent encounter, Open bite of right great toe with damage to nail, sequela, Open bite of left great toe with damage to nail, initial encounter, Open bite of left great toe with damage to nail, subsequent encounter, Open bite of left great toe with damage to nail, sequela, Open bite of right lesser toe(s) with damage to nail, initial encounter, Open bite of right lesser toe(s) with damage to nail, subsequent encounter, Open bite of right lesser toe(s) with damage to nail, sequela, Open bite of left lesser toe(s) with damage to nail, initial encounter, Open bite of left lesser toe(s) with damage to nail, subsequent encounter, Open bite of left lesser toe(s) with damage to nail, sequela, Crushing injury of right great toe, initial encounter, Crushing injury of right great toe, subsequent encounter, Crushing injury of right great toe, sequela, Crushing injury of left great toe, initial encounter, Crushing injury of left great toe, subsequent encounter, Crushing injury of left great toe, sequela, Crushing injury of right lesser toe(s), initial encounter, Crushing injury of right lesser toe(s), subsequent encounter, Crushing injury of right lesser toe(s), sequela, Crushing injury of left lesser toe(s), initial encounter, Crushing injury of left lesser toe(s), subsequent encounter, Crushing injury of left lesser toe(s), sequela, Burn of third degree of right thumb (nail), initial encounter, Burn of third degree of right thumb (nail), subsequent encounter, Burn of third degree of right thumb (nail), sequela, Burn of third degree of left thumb (nail), initial encounter, Burn of third degree of left thumb (nail), subsequent encounter, Burn of third degree of left thumb (nail), sequela, Burn of third degree of single right finger (nail) except thumb, initial encounter, Burn of third degree of single right finger (nail) except thumb, subsequent encounter, Burn of third degree of single right finger (nail) except thumb, sequela, Burn of third degree of single left finger (nail) except thumb, initial encounter, Burn of third degree of single left finger (nail) except thumb, subsequent encounter, Burn of third degree of single left finger (nail) except thumb, sequela, Burn of third degree of multiple right fingers (nail), not including thumb, initial encounter, Burn of third degree of multiple right fingers (nail), not including thumb, subsequent encounter, Burn of third degree of multiple right fingers (nail), not including thumb, sequela, Burn of third degree of multiple left fingers (nail), not including thumb, initial encounter, Burn of third degree of multiple left fingers (nail), not including thumb, subsequent encounter, Burn of third degree of multiple left fingers (nail), not including thumb, sequela, Burn of third degree of multiple right fingers (nail), including thumb, initial encounter, Burn of third degree of multiple right fingers (nail), including thumb, subsequent encounter, Burn of third degree of multiple right fingers (nail), including thumb, sequela, Burn of third degree of multiple left fingers (nail), including thumb, initial encounter, Burn of third degree of multiple left fingers (nail), including thumb, subsequent encounter, Burn of third degree of multiple left fingers (nail), including thumb, sequela, Corrosion of third degree of right thumb (nail), initial encounter, Corrosion of third degree of right thumb (nail), subsequent encounter, Corrosion of third degree of right thumb (nail), sequela, Corrosion of third degree of left thumb (nail), initial encounter, Corrosion of third degree of left thumb (nail), subsequent encounter, Corrosion of third degree of left thumb (nail), sequela, Corrosion of third degree of single right finger (nail) except thumb, initial encounter, Corrosion of third degree of single right finger (nail) except thumb, subsequent encounter, Corrosion of third degree of single right finger (nail) except thumb, sequela, Corrosion of third degree of single left finger (nail) except thumb, initial encounter, Corrosion of third degree of single left finger (nail) except thumb, subsequent encounter, Corrosion of third degree of single left finger (nail) except thumb, sequela, Corrosion of third degree of multiple right fingers (nail), not including thumb, initial encounter, Corrosion of third degree of multiple right fingers (nail), not including thumb, subsequent encounter, Corrosion of third degree of multiple right fingers (nail), not including thumb, sequela, Corrosion of third degree of multiple left fingers (nail), not including thumb, initial encounter, Corrosion of third degree of multiple left fingers (nail), not including thumb, subsequent encounter, Corrosion of third degree of multiple left fingers (nail), not including thumb, sequela, Corrosion of third degree of multiple right fingers (nail), including thumb, initial encounter, Corrosion of third degree of multiple right fingers (nail), including thumb, subsequent encounter, Corrosion of third degree of multiple right fingers (nail), including thumb, sequela, Corrosion of third degree of multiple left fingers (nail), including thumb, initial encounter, Corrosion of third degree of multiple left fingers (nail), including thumb, subsequent encounter, Corrosion of third degree of multiple left fingers (nail), including thumb, sequela, Burn of third degree of right toe(s) (nail), initial encounter, Burn of third degree of right toe(s) (nail), subsequent encounter, Burn of third degree of right toe(s) (nail), sequela, Burn of third degree of left toe(s) (nail), initial encounter, Burn of third degree of left toe(s) (nail), subsequent encounter, Burn of third degree of left toe(s) (nail), sequela, Corrosion of third degree of right toe(s) (nail), initial encounter, Corrosion of third degree of right toe(s) (nail), subsequent encounter, Corrosion of third degree of right toe(s) (nail), sequela, Corrosion of third degree of left toe(s) (nail), initial encounter, Corrosion of third degree of left toe(s) (nail), subsequent encounter, Corrosion of third degree of left toe(s) (nail), sequela, Superficial frostbite of right finger(s), initial encounter, Superficial frostbite of right finger(s), subsequent encounter, Superficial frostbite of right finger(s), sequela, Superficial frostbite of left finger(s), initial encounter, Superficial frostbite of left finger(s), subsequent encounter, Superficial frostbite of left finger(s), sequela, Superficial frostbite of right toe(s), initial encounter, Superficial frostbite of right toe(s), subsequent encounter, Superficial frostbite of right toe(s), sequela, Superficial frostbite of left toe(s), initial encounter, Superficial frostbite of left toe(s), subsequent encounter, Superficial frostbite of left toe(s), sequela.

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