Advertisement
-
1
Drake LA, Scher RK, Smith EB, et al: Effect of onychomycosis on quality of life. .J Am Acad Dermatol 38::702. ,1998. .
-
2
Elewski BE: The effect of toenail onychomycosis on patient quality of life. .Int J Dermatol 36::754. ,1997. .
-
3
Scher RK: Onychomycosis is more than a cosmetic problem. .Br J Dermatol 130: (suppl 43):15. ,1994. .
-
4
Levy LA: Epidemiology of onychomycosis in special-risk populations. .JAPMA 87::546. ,1997. .
-
5
Marsella R, Moretto D: Onychomycosis in Rome, Italy. .Mycopathologia 136::25. ,1996. .
-
6
Evans EG, Sigurgeirsson B, for the Lion Study Group: Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. .BMJ 318::1031. ,1999. .
-
7
Midgley G, Moore MK, Cook JC, et al: Mycology of nail disorders. .J Am Acad Dermatol 31::568. ,1994. .
-
8
Drake LA, Dinehart SM, Farmer ER, et al: Guidelines of care for superficial mycotic infections of the skin: onychomycosis. .J Am Acad Dermatol 34::116. ,1996. .
-
9
De Backer M, De Keyser P, De Vroey C, et al: A 12-week treatment for dermatophyte toe onychomycosis: terbinafine 250 mg/day vs. itraconazole 200 mg/day—a double-blind comparative trial. .Br J Dermatol 134: (suppl 46):16. ,1996. .
-
10
Helfand AE: Onychomycosis in the aged: an administrative perspective. .JAPMA 76::142. ,1986. .
-
11
Podiatry Billing Guide: debridement of mycotic nails, January 2000. Available at: http://www.hgsa.com/professionals/bguides/podiatry.shtml. Accessed August 14, 2003..
-
12
Rosenbach ML, Schneider JE: The Burden of Onychomycosis in the Medicare Population, Sandoz Pharmaceutical Corp, East Hanover, NJ, 1990..
-
13
American Podiatric Medical Association: Medicare Data Report 1997, American Podiatric Medical Association, Bethesda, MD, 1997..
-
14
American Podiatric Medical Association: Medicare Data Report 1999, American Podiatric Medical Association, Bethesda, MD, 1999..
-
15
Documentation guidelines for evaluation and management services. GHI Medicare Newsletter, December 1994..
-
16
Podiatry online. Available at: http://www.footdoc.com. Accessed August 14, 2003..
-
17
American Medical Association: Physicians’ Current Procedural Terminology 1998, American Medical Association, Chicago, 1998..
-
18
1999 procedure code utilization by specialty used in developing the practice expense impact. Shown in the November 1, 2000, final rule. Available at: http://www.cms.hhs.gov. Accessed August 14, 2003..
Onychauxic Dystrophic Toenails Requiring Debridement in Medicare Patients
Prevalence and Anatomical Distribution
Six hundred twenty-nine Medicare patients were evaluated for the presence of onychauxic toenails that in the judgment of the examiners required reduction. Forty-two percent of this group had five or fewer toenails requiring reduction and 24.3% had six or more toenails requiring reduction. Statistics reported by a regional Medicare-contracted carrier for the years 1997 to 1999 showed that 95% of claims submitted for nail debridement were for six or more nails and 5% were for five or fewer nails. The 1999 Medicare Part B data listed the top 300 Current Procedural Terminology (CPT) foot-care codes in order of utilization. Code 11721 (debridement of six or more nails) was number one. National statistics from the Health Care Financing Administration in 1999 indicated approximately a 5:1 ratio in favor of CPT code 11721 (six or more nails). In contrast, this study found a ratio of 2:1 in favor of CPT code 11720 (five or fewer nails). (J Am Podiatr Med Assoc 93(5): 388-391, 2003)
