CommercialBilling CodesLow impact
11.08.17l, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toenails
Independence Blue Cross·PA · Podiatry, Dermatology, General Practice +1 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 11.08.17l with no substantive coverage changes, but updated ICD-10 diagnosis codes effective 10/01/2025. Attachment B added E11.A (Type 2 diabetes in remission), Attachment C replaced generic G35 (Multiple sclerosis) with seven new MS subtype codes, and deleted the old G35 code. These are diagnostic code updates only and do not affect medical necessity criteria or billing procedures for toenail debridement.
Action Required
By 10/01/2025: Billing and coding team must update diagnosis code mappings in the billing system and EMR to reflect the new multiple sclerosis ICD-10 subcodes (G35.A, G35.B0-B2, G35.C0-C2, G35.D). Remove the generic G35 code from any legacy billing rules or templates. Add E11.A to diabetes diagnosis code lists if not already present. Verify that claims for toenail debridement (CPT 11720, 11721) submitted with these updated MS codes will map correctly to policy Attachment C qualifying diagnoses. No changes to prior authorization, medical necessity criteria, or coverage determinations are required. Communicate updated diagnosis codes to providers and ensure EMR templates reflect the new MS code specificity.