Please visit the. Make sure your hands and feet are clean before and after trimming. They may prescribe you antibiotics to treat any underlying infection. Some people have compromised immune systems, so infection is a concern for them. If you would like to extend your session, you may select the Continue Button. Medicare will cover treatments for treatment for an ingrown toenail as long as your doctor deems it medically necessary. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; These services should be reported with quantity of one in the quantity/units field. Make sure your hands and feet are clean before and after trimming. The views and/or positions presented in the material do not necessarily represent the views of the AHA. If your toenails are not taken care of, they may cause injury by scratching or puncturing your skin, breaking off and exposing delicate skin under the nail, or by tearing off because of snagging on clothing or other materials. Based on annual ICD-10 updates for 2022, ICD-10 code E75.244 was added to Group 1 and Group 4 covered diagnoses. Another option is to use the Download button at the top right of the document view pages (for certain document types). Find Medicare.gov on facebook (link opens in a new tab), Follow Medicare.gov on Twitter (link opens in a new tab), Find Medicare.gov on YouTube (link opens in a new tab), A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services. that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. Was your Medicare claim denied? Does Medicare Cover Nail Trimming? To cut toenails, the podiatrist will charge you up to $70. Avoid cutting the skin and do not cut calluses. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. The areas must be tested randomly since the loss of protective sensation may be patchy in distribution, and the patient may get clues if the test is done rhythmically. The new HMO-style Medicare advantage plans usually cover 100%, minus any co-pay the plan has in place. But it does cover treatments that Medicare considers medically necessary. Try entering any of this type of information provided in your denial letter. New Medicare benefits available for people with chronic conditions, How orthotics can keep you running longer. We do not offer every plan available in your area. Its highly contagious, and will spread to others at the pedicure salon you go to- that may even be where you picked it up in the first place! Nail surgery is often performed to remove benign and malignant nail tumors, relieve pain caused by ingrown and traumatized nails, manage disease processes, and diagnose challenging lesions and dystrophies. American Medical Association. This is important, because cutting your toenails too short could heighten your risk for ingrown toenails. For treatment of mycotic nails, or onychogryphosis, or onychauxis (codes 11719, 11720, 11721 and G0127), in the absence of a systemic condition or where the patient has evidence of neuropathy, but no vascular impairment, for which class findings modifiers are not required, ICD-10 CM code B35.1, L60.2 or L60.3 respectively, must be reported as primary, with the diagnosis representing the patients symptom reported as the secondary ICD-10-CM code. clipping and debriding of a nail distal to the eponychium. How much does it cost to get toenails cut? You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. Medicare doesnt usually cover routine foot care. There are several signs of claw toe: Your toes are bent upward (extension) from the joints at the ball of the foot. End User Point and Click Amendment: Routine foot care includes services such as treatment for or fittings for orthopedic shoes, when those services are not medically necessary. The class findings, outlined below, or the presence of qualifying systemic illnesses causing a peripheral neuropathy, must be present and grant the presumption of coverage. Medicare will cover toenail cutting with a podiatrist. that coverage is not influenced by Bill Type and the article should be assumed to End User Point and Click Amendment:CPT codes, descriptions and other data only are copyright 2021 American Medical Association. Trim nail straight across without curving down at the ends. Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesnt cover - like vision, hearing, or dental. pedicures. You'll start receiving the latest news, benefits, events, and programs related to AARP's mission to empower people to choose how they live as they age. The page could not be loaded. Clipping, trimming, or debridement of nails, including debridement of mycotic nails; Shaving, paring, cutting or removal of keratoma, tyloma, and heloma; Non-definitive simple, palliative treatments like shaving or paring of plantar warts which do not require thermal or chemical cautery and curettage; In the case of ambulatory patients there exists: In the case of non-ambulatory patients there exists: 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. Peripheral neuropathy treatment. Does Medicare pay for podiatrist to cut toenails? - Wise-Answer Does Medicare Cover Podiatry | Bunion Surgery | Ingrown Toenails In severe conditions, the nail may come loose from the nail bed and a secondary infection may develop. Try using the MCD Search to find what you're looking for. Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. The CMS.gov Web site currently does not fully support browsers with Speak with a Licensed Medicare Sales Agent 877-388-0596 - TTY 711 (M-F 8am-9pm, Sat 8am-8pm EST | Sunday Closed), 877-388-0596 - TTY 711 (M-F 8am-9pm, Sat 8am-8pm EST | Sunday Closed). Medicare doesnt cover these except in specific circumstance. All other Codes (ICD-10, Bill Type, and Revenue) have moved to Articles for DME MACs, as they have for the other Local Coverage MAC types. The contractor information can be found at the top of the document in the Contractor Information section (expand the section to see the details). Gehwol Nail Softener works quickly and painlessly to soften hard and difficult to trim nails. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, L33636 - Routine Foot Care and Debridement of Nails, PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); SINGLE LESION, PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); 2 TO 4 LESIONS, PARING OR CUTTING OF BENIGN HYPERKERATOTIC LESION (EG, CORN OR CALLUS); MORE THAN 4 LESIONS, TRIMMING OF NONDYSTROPHIC NAILS, ANY NUMBER, DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5, DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 6 OR MORE, Late congenital syphilitic polyneuropathy, Vitamin B12 deficiency anemia due to intrinsic factor deficiency, Other biotin-dependent carboxylase deficiency, Diabetes mellitus due to underlying condition with diabetic mononeuropathy, Diabetes mellitus due to underlying condition with diabetic polyneuropathy, Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy, Diabetes mellitus due to underlying condition with diabetic amyotrophy, Diabetes mellitus due to underlying condition with other diabetic neurological complication, Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene, Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene, Diabetes mellitus due to underlying condition with other circulatory complications, Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy, Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy, Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication, Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene, Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene, Drug or chemical induced diabetes mellitus with other circulatory complications, Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy, Type 1 diabetes mellitus with diabetic mononeuropathy, Type 1 diabetes mellitus with diabetic polyneuropathy, Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy, Type 1 diabetes mellitus with diabetic amyotrophy, Type 1 diabetes mellitus with other diabetic neurological complication, Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene, Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene, Type 1 diabetes mellitus with other circulatory complications, Type 1 diabetes mellitus with diabetic neuropathic arthropathy, Type 2 diabetes mellitus with diabetic mononeuropathy, Type 2 diabetes mellitus with diabetic polyneuropathy, Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy, Type 2 diabetes mellitus with diabetic amyotrophy, Type 2 diabetes mellitus with other diabetic neurological complication, Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene, Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene, Type 2 diabetes mellitus with other circulatory complications, Type 2 diabetes mellitus with diabetic neuropathic arthropathy, Other specified diabetes mellitus with diabetic polyneuropathy, Other specified diabetes mellitus with other diabetic neurological complication, Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene, Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene, Other specified diabetes mellitus with other circulatory complications, Other specified diabetes mellitus with diabetic neuropathic arthropathy, Deficiency of other specified B group vitamins, Defects in post-translational modification of lysosomal enzymes, Other disorders of glycoprotein metabolism, Wild-type transthyretin-related (ATTR) amyloidosis, Early-onset cerebellar ataxia, unspecified, Paraneoplastic neuromyopathy and neuropathy, Other systemic atrophy primarily affecting central nervous system in neoplastic disease, Neuropathy in association with hereditary ataxia, Other hereditary and idiopathic neuropathies, Chronic inflammatory demyelinating polyneuritis, Polyneuropathy in diseases classified elsewhere, Other disorders of peripheral nervous system, Sequelae of other inflammatory polyneuropathy, Lambert-Eaton syndrome in disease classified elsewhere, Lambert-Eaton syndrome in neoplastic disease, Myasthenic syndromes in other diseases classified elsewhere, Unspecified atherosclerosis of native arteries of extremities, right leg, Unspecified atherosclerosis of native arteries of extremities, left leg, Unspecified atherosclerosis of native arteries of extremities, bilateral legs, Atherosclerosis of native arteries of extremities with intermittent claudication, right leg, Atherosclerosis of native arteries of extremities with intermittent claudication, left leg, Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs, Atherosclerosis of native arteries of extremities with rest pain, right leg, Atherosclerosis of native arteries of extremities with rest pain, left leg, Atherosclerosis of native arteries of extremities with rest pain, bilateral legs, Atherosclerosis of native arteries of right leg with ulceration of ankle, Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot, Atherosclerosis of native arteries of right leg with ulceration of other part of foot, Atherosclerosis of native arteries of left leg with ulceration of thigh, Atherosclerosis of native arteries of left leg with ulceration of ankle, Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot, Atherosclerosis of native arteries of left leg with ulceration of other part of foot, Atherosclerosis of native arteries of other extremities with ulceration, Atherosclerosis of native arteries of extremities with gangrene, right leg, Atherosclerosis of native arteries of extremities with gangrene, left leg, Atherosclerosis of native arteries of extremities with gangrene, bilateral legs, Other atherosclerosis of native arteries of extremities, right leg, Other atherosclerosis of native arteries of extremities, left leg, Other atherosclerosis of native arteries of extremities, bilateral legs, Thromboangiitis obliterans [Buerger's disease], Other specified peripheral vascular diseases, Aortitis in diseases classified elsewhere, Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere, Phlebitis and thrombophlebitis of superficial vessels of right lower extremity, Phlebitis and thrombophlebitis of superficial vessels of left lower extremity, Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral, Phlebitis and thrombophlebitis of right femoral vein, Phlebitis and thrombophlebitis of left femoral vein, Phlebitis and thrombophlebitis of femoral vein, bilateral, Phlebitis and thrombophlebitis of right iliac vein, Phlebitis and thrombophlebitis of left iliac vein, Phlebitis and thrombophlebitis of iliac vein, bilateral, Phlebitis and thrombophlebitis of right popliteal vein, Phlebitis and thrombophlebitis of left popliteal vein, Phlebitis and thrombophlebitis of popliteal vein, bilateral, Phlebitis and thrombophlebitis of right tibial vein, Phlebitis and thrombophlebitis of left tibial vein, Phlebitis and thrombophlebitis of tibial vein, bilateral, Phlebitis and thrombophlebitis of right peroneal vein, Phlebitis and thrombophlebitis of left peroneal vein, Phlebitis and thrombophlebitis of peroneal vein, bilateral, Phlebitis and thrombophlebitis of right calf muscular vein, Phlebitis and thrombophlebitis of left calf muscular vein, Phlebitis and thrombophlebitis of calf muscular vein, bilateral, Phlebitis and thrombophlebitis of other deep vessels of right lower extremity, Phlebitis and thrombophlebitis of other deep vessels of left lower extremity, Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral, Chronic embolism and thrombosis of right tibial vein, Chronic embolism and thrombosis of left tibial vein, Chronic embolism and thrombosis of tibial vein, bilateral, Embolism and thrombosis of superficial veins of right lower extremity, Embolism and thrombosis of superficial veins of left lower extremity, Embolism and thrombosis of superficial veins of lower extremities, bilateral, Chronic embolism and thrombosis of other specified veins, Blind loop syndrome, not elsewhere classified, Postsurgical malabsorption, not elsewhere classified, Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot, Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot, Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot, Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot, Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement, Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or systems involvement, Other rheumatoid arthritis with rheumatoid factor of right ankle and foot, Other rheumatoid arthritis with rheumatoid factor of left ankle and foot, Rheumatoid arthritis without rheumatoid factor, right ankle and foot, Rheumatoid arthritis without rheumatoid factor, left ankle and foot, Other specified rheumatoid arthritis, right ankle and foot, Other specified rheumatoid arthritis, left ankle and foot, Other conditions related to polyarteritis nodosa, Chronic kidney disease, stage 3 unspecified, Difficulty in walking, not elsewhere classified, Some older versions have been archived. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. shower. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. . For the asterisked conditions below, the name of the primary physician (must be a D.O. Nail avulsions usually offer only temporary relief for ingrown toenails. This Agreement will terminate upon notice if you violate its terms. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM). To distinguish debridement from trimming or clipping, Medicare expects records to contain some description of the debridement procedure beyond simple statements such as "nail(s) debrided." . Cut your toenails straight across, do not cut into the curve around the end of the nail. Find Medicare.gov on facebook (link opens in a new tab), Follow Medicare.gov on Twitter (link opens in a new tab), Find Medicare.gov on YouTube (link opens in a new tab), A federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services. You can call one of our offices in Arlington or Dallas, Texas, or use the booking tool here on our website. Routine identification of fungi in the toenail either by culture or similarly by either nucleic acid probes or amplified probe technique only is medically indicated only when necessary to differentiate fungal disease from psoriatic nail, or when definitive treatment for prolonged oral antifungal therapy has been planned and there must be adequate Also Check: How Can Type 2 Diabetes Be Treated. As a result, an E&M service billed on the same day as a routine foot care service is not eligible for reimbursement unless the E&M service is a significant separately identifiable service, indicated by the use of modifier 25, and documented by medical records. . If you are acting on behalf of an organization, you represent that you are authorized to act on behalf of such organization and that your acceptance of the terms of this agreement creates a legally enforceable obligation of the organization. PDF Does Medicare Pay for Toenail Care? - cbfootcare.com Failure to properly document the reasoning for the care rendered may result in denial of the claim. THE UNITED STATES Treatment of mycotic nails may be covered under the exceptions to the routine foot care exclusion. Foot care (routine) | Medicare Applicable FARS\DFARS Restrictions Apply to Government Use. AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. Deciding Whether to Go to the Doctor or a Salon for Foot Care "Take your loved one for a spa pedicure every two months. This nerve damage may cause numbness, tingling, foot deformities such as hammertoes, and may even change the way a person walks. Surgery OverviewCryotherapy involves freezing a wart using a very cold substance . What may start as a small problem can become a painful and dangerous condition if it is not cared for immediately. Section 1862 (a) (1) (A) excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Leave the nails a little longer at the corners so that the sharp ends don't cut into the skin. This falls under Medicare Part B and there are conditions. b. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. Do not be afraid to call other Podiatrist to get price quotes. For ingrown toenails, a podiatrist may remove a section of the nail and give you a prescription to treat the infection. Your condition needs to be under treatment by a physician to qualify for coverage. Find out more. LOPS shall be diagnosed through sensory testing with the 5.07 monofilament using established guidelines, such as those developed by the National Institute of Diabetes and Digestive and Kidney Diseases guidelines. Further, Medicare will pay for diabetic foot care every six months. Dont Miss: What Will Diabetes Do To Your Body. A Non-Government Resource For Healthcare All Rights Reserved 2023. Upon completion, nail debridement should result in a Therapeutic shoes, eligible foot exams for people with diabetic nerve damage, and other qualified foot care from a podiatrist are covered underMedicare Part Bafter you pay the annual Part B deductible, which is $233 in 2022 and $226 in 2023. Joint replacements, heart valve replacements, blood clots, atrial fibrillation and cancer are just a few of the conditions that cause patients to take these medications.The way you know if you are on one of these medications is very simple, do you have to check your INR? Most Podiatrists will charge you, if you pay out of pocket, 50 dollars or less. A podiatrist will remove the section of your toenail that has become ingrown and is causing you pain. You will find them in the Billing & Coding Articles. A doctor has been treating you for diabetes in the six months before the nail clipping. A. (Or, for DME MACs only, look for an LCD.) Only your podiatrist can diagnose you as an at-risk patient for nail care. How Often Does Medicare Pay for Podiatrist Services? Does Medicare Cover Care for Ingrown Toenails. Physical therapy Stretching and strengthening exercises can be a great first line of defense to help reverse the muscle imbalance that causes a hammertoe. Does Medicare Cover Care for Ingrown Toenails? Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy. Routine foot care includes: Cutting or removing corns and calluses Trimming, cutting, or clipping nails Hygienic or other preventive maintenance, like cleaning and soaking your feet Things to know Note Some Medicare Advantage Plans (Part C) offer extra benefits that Original Medicare doesn't cover - like vision, hearing, or dental. An asterisk (*) indicates a En espaol |No, but routine foot care may be different things to different people. apply equally to all claims. How do you fix hammer toe without surgery? Medicare will cover treatments for treatment for an ingrown toenail as long as your doctor deems it medically necessary. Does Medicare Cover Ingrown Toenails? | HelpAdvisor.com Thats because they may developneuropathy, which is nerve damagein the feet and legs, or peripheral artery disease, which reduces blood flow to the feet. AHA copyrighted materials including the UB‐04 codes and CMS and its products and services are PDF Foot Care and Podiatry Services - UHCprovider.com normally are considered routine and not covered by Medicare include the following: The cutting or removal of corns and calluses; The trimming, cutting, clipping, or debriding of nails . Does Medicare Cover Podiatry? | MedicareSupplement.com Additionally, is wart removal considered surgery? When you receive medically necessary foot care as an outpatient, it will be covered under . Why Proper Toenail Trimming is Important Please refer to the CMS website for instructions for billing Part A and Part B claims. But the coverage is conditional. However, please note that once a group is collapsed, the browser Find function will not find codes in that group. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be During the diabetic foot exam, have your physician check for adequate blood flow and for any sign of loss of feeling in your feet. A podiatrist will remove the section of your toenail that has become ingrown and is causing you pain. People with diabetes, who are prone to nerve damage that can affect feet and legs, are eligible for extra foot-related coverage. Thus, diabetes and smoking are not a good mix. Medicare will cover routine foot care as often as is medically necessary . Debridement of these toenails may be warranted in the presence of secondary infection and pain to a degree Come in to Podiatry Associates, P.C. Medicare contractors are required to develop and disseminate Articles. Current Dental Terminology © 2022 American Dental Association. DISCLOSED HEREIN. The program covers drugs that are furnished "incident-to" a physician's service provided that the drugs are not "usually self-administered" by the patient. If you have diabetes, it is even more important for you to care for feet and toenails meticulously. Medicare will cover debridement of mycotic nails as an adjunct to pharmacologic treatment with a prescription antifungal agent indicated per its Food and Drug Administration (FDA) label for the treatment of fungal nail infections. This should include, but is not limited to, the size (including thickness) and color of each affected nail. In an overview of diabetic neuropathy, the Mayo Clinic explains that high blood sugar can cause damage to nerves throughout the body and frequently injures the nerves in the feet as well as the legs. Some articles contain a large number of codes. For Government Resources Regarding Medicare, Please Visit www.medicare.gov. It is recommended to use a toenail clipper designed for the toes, which typically cost about $3-$6, and to clip toenails straight across to prevent recurring ingrown toenails. Please note that according to the NIDDK, smoking can narrow and harden the blood vessels that deliver oxygen and nutrients to your nerves, and nerve damage and decreased blood flow can cause major foot problems. diabetes, arteriosclerosis , rheumatoid arthritis, peripheral neuropathy, multiple sclerosis, arteritis, chronic kidney disease, ALS, leprosy, syphilis related nerve disease, beriberi, pellagra, lipidoses, amyloidosis, pernicious anemia, Freidreichs ataxia, quadriplegia or paraplegia, Refsums disease, polyneuritis, toxic myoneural disease, Raynauds disease, erythromelalgia, phlebitis , celiac disease, tropical sprue, blind loop syndrome, pancreatic steatorrhea, Recommended Reading: What Is A Smart Insulin Pen. Evidence of several infections caused by the fungus may also qualify you. < Medicare covers nail debridement for non-ambulatory beneficiaries with clinical evidence of pain or a secondary infection resulting from one or more mycotic toenails. MACs can be found in the MAC Contacts Report. Contact your local foot doctor to have an evaluation and set up a regular schedule to have the foot care you need done safely. Keep all your trimming tools clean by washing or wiping them with rubbing alcohol. If you are able to trim your own toenails, following these procedures may make it easier and safer: Soak your feet before trimming your toenails or cut them after taking a bath or The patient is responsible for the 20% coinsurance plus the deductible. CPT codes 17110 and 17111 should be used for flat warts and molluscum contagiosum destruction, and 17000 and 17003 are appropriate to report plantar wart removal. But the important question is: Does Medicare cover foot care? Unfortunately, as we age, several factors conspire to make this seemingly simple task more difficult. If you have diabetes-related lower leg nerve damage that can increase the risk of limb loss, Medicare covers foot exams every six months. CMS believes that the Internet is 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. I am talking about a group of medications that are used for no other purpose then to slow the clotting of blood. Medicare will cover no more than six (6) debridement sessions per patient per 12 months absent medical review of patient records demonstrating medical necessity. The longer they are, the more you risk them breaking, snagging on clothing, or scratching skin open accidentally.
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