I will repeat my answer from before in this thread...
"So long as the EM is significant and separately identifiable from the nail debridement, yes(it can be billed). If the EM was just to assess the nails and decide to do the debridement, no. That is built into the 11721 already."
Basically, the patient has to have a separate problem(s) in order to bill the E/M with the nail debridement, and the E/M level chosen has to meet 3/3 requirements for a new pt, and 2/3 requirements for an established patient. If you have that, you can bill the E/M, if not, you can't.