Medicare AdvantageBilling CodesMedium impact
MA11.014h, Debridement of Mycotic and Symptomatic Non-Mycotic Hypertrophic Toe Nails
Independence Blue Cross·Podiatry, General Surgery, Family Medicine +1 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated ICD-10 diagnosis codes for MA11.014h toe nail debridement policy effective 10/01/2025. Added E11.A (Type 2 diabetes in remission) to Attachment B and replaced the generic G35 (Multiple sclerosis) code with seven new MS-specific codes (G35.A through G35.D) in Attachment C. The policy coverage criteria and reimbursement methodology remain unchanged; only diagnosis code references were updated to align with new ICD-10 CM coding standards.
Action Required
By 10/01/2025: Billing team must update diagnosis code references in billing system and claims submission software to recognize the seven new G35.A-G35.D multiple sclerosis codes (replacing the deleted generic G35 code) and add E11.A for Type 2 diabetes in remission. Update encounter forms and EMR templates used by providers documenting nail debridement procedures to reference only the new MS codes. For claims submitted after 10/01/2025 with toe nail debridement, validate that multiple sclerosis diagnoses use the new specific G35 codes; claims using the old G35 code will likely be rejected. Notify in-house providers and contracted podiatrists of the code changes to ensure proper documentation at point of service.