Medical Articles

Cheat Sheet / Updated 11-13-2024

Working as a medical biller and coder is a challenging and rewarding job that takes you right into the heart of the medical industry. You are the touchpoint for everyone involved in the healthcare experience, from the patient and front office staff to providers and payers. To succeed, you'll need to know how to file an error-free claim, important acronyms, and what to look for in a payer contract.

Cheat Sheet / Updated 04-25-2022

With the right approach and preparation you can give yourself a head start in applying to nursing school in the U.K. This Cheat Sheet gives you the key things to know about the application timeline, choosing the right university, writing your personal statement and preparing for assessments and interviews.

Cheat Sheet / Updated 04-25-2022

Getting into medical school is extremely competitive, and the application process is long and complex. Keeping track of the application timeline is essential because early applicants are at an advantage when it comes to getting admitted to medical school. The Medical College Admission Test (MCAT) is a particularly important part of the admissions decision, and doing well on it will greatly enhance your chances of acceptance. Your primary application contains many elements of your application package, including your personal statement, course work, and activities, so make sure you invest the time and effort needed to present your candidacy for medical school as effectively as possible on this document.

Cheat Sheet / Updated 01-20-2022

No matter what initials you have after your name (RN, CNA, PA, and so on), you can bet you’ll see math on a daily basis if you’re going into (or are already in) a career in the medical field. Grasping some medical math basics — such as how to break down medical dosage problems into steps and use conversion factors — can simplify everyday situations all health care professionals face. In addition to just knowing math, you’re going to need to know how to read and interpret doctors’ orders, and spot when there’s potential trouble.

Cheat Sheet / Updated 09-15-2021

Vaccinations are a hot topic today. While vaccines can have some side effects, the benefits outweigh any possible risks. Vaccines have saved untold numbers of lives. Many previously feared childhood and adult diseases have been eliminated. Take a look at the entire vaccination process.

Article / Updated 08-11-2021

What makes up the inside of your body, from cells to organs and everything in between, lends itself to an abundance of body part-related medical terms. All the root words and combining forms can morph into all kinds of different words that explain everything from everyday common conditions and procedures to pathology and pharmacology. Remember that you can take any root word or combining form and create several different medical terms. Root Word What It Means Example(s) Abdomin/o Abdomen Abdominoplasty: Surgical repair or reconstruction of the abdomen Angi/o Vessel Angioplasty: Surgical repair or reconstruction of a vessel Arteri/o Artery Arterioplasty: Surgical repair or reconstruction of an artery Arthr/o Joint Arthritis: Inflammation of a joint Arthroplasty: Surgical repair or reconstruction of a joint Audi/o Hearing Audiometry: Measurement of hearing using an audiometer Bio Life Biology: The study of life and living organisms Bronch/i, bronch/o Bronchus/lung Bronchitis: Inflammation of the bronchi Bronchoscopy: Visual examination of the bronchi Cardi/o Heart Cardiomegaly: Enlargement of the heart Cardiac: Pertaining to the heart Carditis: Inflammation of the heart Cholecyst/o Gallbladder Cholecystectomy: Removal of the gallbladder Cholecystitis: Inflammation of the gallbladder Chondr/i, chondr/o Cartilage Chondromalacia: Softening of cartilage Col/o Colon Colonoscopy: Visual examination of the colon Colonoscope: Instrument used in colonoscopy Cry/o Cold Cryobiology: Branch of biology dealing with effects of low temperatures Cysti, cyst/o Bladder, or cyst Cystectomy: Surgical removal of a simple cyst or of the urinary bladder Cystitis: Inflammation of the bladder Cystogram: Radiograph of the bladder Cystopexy: Surgical fixation of the bladder to abdominal wall Cyt/o Cell Cytology: Study of cells Duoden/o Duodenum Duodenotomy: Surgical cutting into the duodenum Duodenectomy: Surgical removal of the duodenum Duodenitis: Inflammation of the duodenum Encephal/o Brain Encephalitis: Inflammation of the brain Episi/o Vulva Episiotomy: Surgical cutting of the vulva Erythr/o Red Erythrocytes: Red blood cells Erythema: Reddening of the skin Esophag/o Esophagus Esophagitis: Inflammation of the esophagus Esophagogastroduodenoscopy (EGD): Visual examination of the esophagus, stomach, and duodenum by scope Galact/o Milk Galactorrhea: Spontaneous flow of milk when nursing Gastr/o Stomach Gastritis: Inflammation of the stomach Gastrectomy: Surgical removal of the stomach Gastrodynia: Stomach ache Glyc/o Sugar Glycosuria: Sugar in the urine Gynec/o Female Gynecologist: Physician who studies and treats diseases of female reproductive organs Hemat/o, hem/o Blood Hematocyte: Blood cell Hepat/o, hepatic/o Liver Hepatitis: Inflammation of the liver Heter/o Other, different Heterosexual: Sexually attracted to the opposite sex Hist/o, histi/o Tissue Histology: Study and function of tissue Hom/o, home/o Same, alike Homosexual: Sexually attracted to the same sex Hydr/o Water, wet Hydromassage: Massage by means of moving water Hyster/o Uterus Hysterectomy: Surgical removal of the uterus Ile/o Ileum (intestine) Ileostomy: Artificial opening into the ileum Ileitis: Inflammation of the ileum Ili/o Ilium (pelvic bone) Ilioinguinal: Pertaining to the ilium and inguinal regions Jejun/o Jejunum Jejunitis: Inflammation of the jejunum Jejunostomy: Artificial opening into the jejunum Lacrima Tears Lacrimatory: Causing a flow of tears Laryng/o Larynx Laryngitis: Inflammation of the larynx Laryngectomy: Surgical removal of the larynx Leuk/o White Leukocyte: White blood cell Lith/o Stone or calculus Lithotripsy: Crushing of a stone or calculus Men/o Menstruation Menorrhea: Menstrual flow Menorrhagia: Excessive or heavy menstrual flow Myel/o Bone marrow/spinal cord Myelogram: Recording of the spinal cord My/o Muscle Myositis: Inflammation of a muscle Myalgia: Pain in a muscle or painful muscle Nat/o Birth Prenatal: Before birth Postnatal: After birth Necr/o Death Necrosis: Death of a cell Necrophobia: Morbid fear of death or dead bodies Nephr/o Kidney Nephrectomy: Surgical removal of a kidney Neur/o, neur/i Nerve Neurologist: Physician who studies and treats conditions of the nervous system Oophor/o Ovary Oophorectomy: Surgical removal of an ovary Oophoritis: Inflammation of an ovary Orchid/o, orchi/o Testis Orchialgia: A pain in the testicle Orchiectomy: Surgical removal of a testicle Peritone/o Peritoneum Peritoneal: Pertaining to the peritoneum Peritonitis: Inflammation of the peritoneum Pharyng/o Pharynx Pharyngitis: Inflammation of the pharynx (sore throat) Pleur/o, pleur/a Pleura, rib (side) Pleurisy: Inflammation of the lining of the chest cavity Pleurolysis: Surgical separation of pleural adhesions Pneum/a/o/ato/ono Lungs Pneumonitis: Inflammation of the lung Proct/o Rectum, anus Proctologist: Physician who studies and treats diseases of rectum and anus Pulmon/o Lungs Pulmonary: Pertaining to the lungs Pyel/o Renal pelvis Pyelography: Radiograph (x-ray) of the pelvis of the kidneyPyelolithotomy: Removal of a stone from the kidney pelvis Rect/o Rectum Rectosigmoid: Pertaining to the rectum and sigmoid Salping/o Fallopian tube Salpingectomy: Surgical removal of a fallopian tube Sarc/o Flesh Sarcoid: Resembling flesh Splen/o Spleen Splenomegaly: Enlargement of the spleen Splenectomy: Surgical removal of the spleen Tend/o, ten/o, tendin/o Tendon Tendinitis (or tendonitis): Inflammation of a tendon Testicul/o Testis Testicular: Pertaining to a testis or testicle Testitis: Inflammation of a testis Thorac/o Chest Thoracotomy: Incision into the chest cavity Thoracentesis: Surgical puncture into chest cavity Tonsill/o Tonsils Tonsillectomy: Surgical removal of tonsils Tonsillitis: Inflammation of the tonsils Ureter/o Ureter Ureterolithotomy: Removal of a calculus (stone) from a ureter by means of incision Ureteropelvic: Pertaining to the ureter and pelvis of the kidney Urethr/o Urethra Urethritis: Inflammation of the urethra Urethropexy: Surgical fixation of the urethra Vas/o Vas deferens Vasectomy: Surgical removal of portion of vas deferens for male sterilization Viscer/o Viscera (organs) Viscerography: Radiography of the viscera

Cheat Sheet / Updated 03-14-2021

Grasping medical terminology starts with knowing the body’s systems, recognizing medical root words commonly used, understanding the Greek influence in medical terminology, and learning those pesky hard-to-spell medical words.

Article / Updated 01-23-2020

Before you start job-hunting as a medical billing and coding specialist, give some thought to what sort of environment you want to work in. The possibilities are almost endless, and if you think about your preferences before you search for a job, you can narrow down your list of possible employers, saving yourself a boatload of time. Are you, for example, interested in the fast-paced, volume-heavy work that you’d likely find in a hospital? Or does the controlled chaos of a smaller physician’s office seem more up your alley? The good news is that all medical facilities and offices need some sort of billing and coding staff who can either work in the office or work remotely. Medical billers and coders are essential to the efficient processing of data, compliance with government regulations, and protection of patient privacy as required by the Health Insurance Portability and Accountability Act (HIPAA). Currently, medical billing and coding jobs comprise one-fifth of the healthcare workforce, a number that is expected to grow. The transition to ICD-10, the updated version of the International Classification of Diseases that replaced ICD-9, increased the demand for medical coders because it made the coding and billing process more complicated (due to the increased specificity of the classifications) and more time-consuming. On the heels of ICD-10 is ICD-11, which is tentatively scheduled to become effective after January 1, 2022; ICD-11 will unlikely create concerns that were part of the ICD-10 delay. As you consider where you want to ply your trade, keep in mind that the environment you choose can impact how broad or narrow your exposure to the coding and billing profession is. For example, if you work for a general surgeon (an optimal — and most sought after — position for a coder), you get experience in most areas of coding. The surgeon may use evaluation and management codes in addition to procedural codes from every section of the coding book. In contrast, a position in a pathology laboratory may limit your experience to that area of practice. A coder with experience in all areas becomes more valuable as an employee to the bigger employers. The doctor is in: Working in a physician’s office If you’ve seen someone buried under stacks of medical files as you take care of your copay in the doctor’s office, chances are you’re looking at a medical biller or coder. Just think — that could be you! Several different kinds of physician offices employ their own coders and billers. Here are just a few possibilities: Working in an office in which a group of physicians share a practice: In a multi-physician office, the pace is usually a little faster, and more demands are placed on the administrative staff. Usually, a larger practice has an office manager in addition to the clerical staff. Working in an office that has just one or two docs: In this situation, the coder may function as the receptionist and biller as well. These offices can be great places to work. Due to size, you may find less office politics, and life usually tends to move at a slower pace when you’re dealing with just one doc. The downside is that getting time off can be difficult, and your days off generally correspond to the physician’s days off, so you have less flexibility with regard to personal time. Working in an office in which the physicians do their own coding: In this case, the physicians may use only the services of a biller. A certified coder is optimal to fill this type of position because, when the physician is out of her comfort zone from a coding perspective, a certified coder can assist with assigning the correct codes, as well as keeping abreast of code changes and other requirements. The downside to working in this environment is that your coding may not be as accurate as it should be (you may work with a physician who likes to “do it his way”), and moving to another job will be more difficult. Keeping providers like these on the right track is often a difficult and delicate position to put yourself in. Hooking up with a hospital Get all the images of Grey’s Anatomy out of your head right now. Working in a hospital may be busy and exciting, but it’s not always that dramatic, especially in the “back of house,” where billers and coders do their stuff. That said, working in a hospital environment has a lot to keep you hopping. Working in a hospital can be a rewarding experience for the coder. Hospitals are very departmentalized, with each department having its own coders. In most circumstances, the coding in a particular department is specific to a certain specialty or set of specialties, just as it would be if you were working in a physician’s office. The difference is that the coding is for the facility, so expenses that are incurred by the facility — including drugs and implantable items such as stents or shunts, for example — are reimbursed through the hospital coding. In addition, most hospitals have a centralized billing department (or they may send the billing out to a billing company; see the next section). Medicare and some state Medicaid plans reimburse hospitals based on diagnosis-related groups (for example, MS-DRGs or APR-DRGs) for inpatient claims. This means that the admitting diagnosis is linked to the severity of the patient’s illness. The level of risk associated with the treatment can affect the level of reimbursement received from Medicare and other payers. In other words, the sicker the patient, the greater the risk, and the higher the level of reimbursement. Coding that drives diagnosis related groups (DRGs) is more complex than non-DRG claims. There are specific rules that govern sequencing diagnosis codes and also the documentation that is required to support using those codes. Don’t think that you can’t create a niche for yourself in a larger hospital setting. You can, thanks to all the smaller sub-clinics and offices under the hospital umbrella that service the entire facility. For example, many surgeries can’t be performed without anesthesia (well, they could, but it wouldn’t be a popular choice!). So hospitals use anesthesiologists, who have to bill patients just like any other function of the hospital. Focusing on a billing or practice management company Other options for employment as a biller or coder usually involve working for a practice management or billing company. These companies provide various levels of administrative support, with some handling all of a provider’s practice administrative duties (even though having someone on site who understands insurance is still important for every provider office). Billing and practice management companies come in all sizes and specialties. The larger companies handle numerous clients and usually have a team of people working on one or two of the accounts. In addition, if the company provides practice management — including coding and billing for a physician or group — the work is the same as if the provider were handling this aspect of the practice in-house. Work at a billing or practice management company may be a good bet for the novice coder or biller because it’s a great way to learn the ropes under the tutelage of a more seasoned professional. It also provides an outlet for giving and receiving feedback and working through some of the stickier details with a coworker. In this work environment, you wouldn’t be flying solo! As a general rule, bigger companies usually have more structure with regard to how they do things, and they provide the best on-the-job training. That being said, be mindful of companies that have internal training programs run by people who have only worked at that one company! Just as with hospitals, you can find your own niche in practice management companies, too. Some practice management companies within larger organizations, for example, specialize in certain areas, such as anesthesia or radiological practices. Working for one of these companies enables you to focus on and gain expertise in those specialties. With anesthesia, for example, you would need to know all surgical and procedural codes, and radiology overlaps with cardiology because of the noninvasive cardiac procedures that are now common. Many billing companies are contractually obligated to their clients to employ only certified medical coders to perform the coding. Although the AAPC (American Academy of Professional Coders) now offers a Certified Professional Biller certification, billers may often be trained on the job, but having knowledge prior to employment gives you an advantage as a job seeker. Processing claims for an insurance company You may decide that you want to work in claims. Working in a claims job is one way to stretch the limits of your billing and coding knowledge. Major insurance payers use automated claims processing. The claims are received electronically and do not require a human touch unless there are problems. Smaller payers may either receive the information electronically or scan it into their processing software, where it is processed, ideally correctly. To ensure more efficient, yet timely claim processing, many of these companies also use a claims processor. To be successful as a claims processor, you need to know medical claim coding, billing procedures, and insurance obligations. These processors carefully examine each claim to determine its validity and accuracy. The processor then refers to the patient’s insurance policy benefit or plan to determine the correct level of payment for the claim. The processor also has software that contains the contracts that are linked to individual medical providers by their tax identification number or National Provider Identifier (NPI). They apply the plan provisions and payer contract to the claim to determine payment. After doing all this, the payment is issued accordingly. If the claim needs additional clarification or information, the claims processor sends a notice to the appropriate office to request the missing details. In addition to payer-processing positions, insurance companies also need people to handle incorrectly processed claims when the providers appeal them. Again, solid knowledge of medical terminology, diagnosis, and procedural codes are valuable tools for these employees. The best of the rest The possibilities are nearly endless in the billing and coding field. Even though you’re most likely to find employment in a physician’s office or in a larger facility like a hospital or clinic, here are a few other options you may find enticing: Nursing homes Outpatient facilities Home healthcare services Durable medical equipment providers Federal government agencies such as the Department of Health & Human Services, Social Security, Medicare, Tricare, or the Department of Labor In short, billing and coding is important to any business that provides healthcare. Getting your foot in the door Whether you find work in a doctor’s office, at the local hospital, at a practice management company, or for an insurance company, you have several options for jobs within those offices. Think of the world of billing and coding as a buffet, and you have a plate just waiting to be filled with a big, tasty job. The good news is that you get to pick based on your level of skill and your interests. Still, finding employment as a novice can be a challenge. Many offices are fully staffed and may hesitate to hire a newly trained coder without any medical office experience. An excellent way to get your foot in the door is to accept a position that involves verifying each patient’s benefits.

Article / Updated 01-15-2020

The urinary system is made up of the kidneys (you have two), ureters (also two), bladder, and urethra (one). This system’s main function is to remove urea, the waste product of metabolism, from the bloodstream and excrete the urea (in the urine) from the body. So, how does that big steak dinner you ate last night turn into the next morning’s output in the form of urine? Well, food and oxygen combine in cells to produce energy, a process called catabolism. In the process, food and oxygen are not destroyed, but small particles making up the food and oxygen are rearranged in new combinations, and part of the result is waste products. Waste products in the form of gases (carbon dioxide) are removed from the body by exhaling through the lungs. Nitrogenous waste (the by-product of protein food) is more difficult to excrete from the body than gases. This kind of waste is secreted as a soluble dissolved in water, a waste substance called urine. The main function of the urinary system is to remove urea from the bloodstream. Urea is formed in the liver from ammonia (which is, believe it or not, basically the same stuff you use to clean the kitchen). The bloodstream carries it (in the same manner as hormones and lymph) to the kidneys, where it passes with water, salts, and acids out of the bloodstream into the kidneys. The kidneys remove waste products, producing urine that travels through each ureter into the bladder. Urine is then excreted from the bladder via the urethra. Magically (or so it might seem), your steak dinner has turned into pee! Kidneys You have two kidneys, unless you’ve had one removed. Kidneys are dark reddish brown, bean-shaped organs that are located behind the abdominal cavity on each side of the spine in the lumbar region. They are embedded in a cushion of adipose (fat) tissue and surrounded by connective tissue for support. Each kidney is about the size of a fist and weighs approximately 8 ounces. The left kidney is a little larger and sits a little higher than the right one. Each kidney consists of an outer cortex and an inner medulla region. The cortex contains millions of nephrons, and the medulla contains the collecting tubules (small tubes). A segment on the medial border of each kidney, called the hilum, allows the blood vessels, nerves, and ureter to pass through. The nephron is the kidney’s functional and structural unit, or the “brains” of the kidney. Each is a urine-producing microscopic structure, consisting of a renal corpuscle and renal tubule. Hilum’s Latin meaning is “a small thing or a trifle.” This is a term for a depression or pit in an organ where vessels and nerves enter. Glomeruli (singular glomerulus) are clusters of capillaries (small vessels) at the entrance of each nephron. They help filter the blood, beginning the process of urine production. In the blood-filtering process, water and solutes from the blood in the glomeruli pass through the capillaries and the walls that make up the glomeruli into the tubules. Tubules have the ability to remove substances your body needs and return them to the blood. The Greek word pyelos means “tub-shaped vessel,” which describes the shape of each kidney. Ureters You have two ureters (right and left). They are muscular tubes about 15–18 inches long, lined with mucous membrane, extending from the renal pelvis down to the bladder. The left ureter is longer because the left kidney sits higher in position. The urine enters the bladder in spurts via each ureter every 10–30 seconds. At the bladder entrance is a ureteral orifice (opening) that opens to allow urine into the bladder from each ureter. The orifice works in sequence with the peristaltic (wavelike) action that propels the urine through the ureter. This action prevents urine from flowing back into the ureter when the bladder contracts. Urinary bladder The urinary bladder is a hollow, very elastic muscular sac in the pelvic cavity. It acts as a temporary reservoir or “holding tank” for urine. It has two openings to receive the urine coming from each ureter. Another opening, the urethra, provides an exit route for the urine out of the body. The trigone is a triangular space at the base of the bladder where the ureters enter the bladder. An average bladder holds more than 250 ml of urine before producing the desire to urinate. Contraction of the bladder and internal sphincter is an involuntary action, whereas the action of the external sphincter is controlled by you. The act of preventing or concluding voiding (urination) is learned and voluntary in a healthy body. Urethra The urethra is a membranous tube that carries urine from the bladder to the exterior of the body. The process of expelling or voiding urine is technically called micturition. The external opening of the urethra is the urethral meatus or urinary meatus. The female urethra is about 11/2 inches long, and its only function is urination. In the male, it is approximately 8 inches long. It extends from the bladder neck through the prostate and through the penis. The male urethra carries both urine and reproductive organ secretions. Thanks to Mother Nature, the urethra can’t mix sperm and urine, so it’s difficult to pee with an erection. That sure prevents unwanted embarrassment during those tender moments. Catheter comes from the Greek catheter, meaning “a thing let down.” A catheter lets down urine from the bladder. Micturate comes from the Latin mictus, which means “a making of water.” From the verb micturate comes the noun micturition. Be sure to note the spelling: Micturition (expelling urine) is often misspelled as micturation. The p is silent in pneumonia, just as pee is silent in a swimming pool. That’s why you probably should not frequent swim-up bars on vacation. You never know what is lurking in the water.

Article / Updated 01-03-2020

Your skin (the body’s largest organ), glands, nails, and hair — also known as the integumentary system — serve as the “public face” of your body. Consider it your marketing team, letting the world know by their condition how healthy the rest of your body is. Healthy skin, along with accessory organs glands, hair, and nails, are the hallmarks of healthy insides, so care for them accordingly. Sebaceous and sudoriferous glands The skin has two types of glands that, as accessory organs, produce important secretions. These glands under the skin’s surface are called the sebaceous (oil) glands and the sudoriferous (sweat) glands. The sebaceous glands produce an oily secretion called sebum, whereas the sudoriferous glands produce a watery secretion called sweat. Sebum and sweat are carried to the outer edges of the skin by ducts and excreted through openings in the skin called pores. Sebum helps lubricate the skin. Sebaceous glands are closely associated with hair follicles, and their ducts open into the hair follicle through which the sebum is released. Sebaceous glands are influenced by sex hormones. This causes them to be overactive at puberty and underactive in old age. This explains the excess oil production of the skin at puberty and gradual drying of the skin as we age. Sudoriferous (sweat) glands are tiny coiled glands found on almost all body surfaces. You have about 2 million of them in your body. There are many more in the palms of the hands, and you’d find approximately 3,000 glands per square inch on the sole of your foot. The tiny openings on the surface are called pores. Sweat helps cool the body as it evaporates from the skin surface. Nerve fibers under the skin detect pain, temperature, pressure, and touch. The adjustment of the body to its environment depends on the sensory messages relayed to the brain and spinal cord by the sensitive nerve endings in the skin. Diaphoresis comes from the Greek dia, meaning “through,” and phoreo, meaning “I carry.” Translated, it means “the carrying through of perspiration.” The following figure illustrates the layers of the skin and some of its structures. Stinking it up: Your sweat glands Sweat gets a bad rap for being smelly when, in fact, it’s not your fault. Your body’s smell is caused by bacteria. Sweat or perspiration is almost pure water, with dissolved materials such as salt making up less than 1 percent of its total composition. Sweat is actually colorless and odorless. The odor produced when sweat accumulates is due to the action of bacteria on it. Certain sweat glands, active only from puberty onward and larger than ordinary sweat glands, are concentrated near the reproductive organs and in the axillae (armpits). These glands secrete an odorless sweat that contains substances that are easily broken down by skin bacteria. The breakdown products are responsible for the characteristic “human body odor.” So the next time someone tells you your sweat stinks, you can say, “I beg to differ. My bacteria are the culprits.” The ceruminous glands are classified as modified sweat glands and are found in the ear canal. These glands produce a yellow waxy substance called cerumen (ear wax). Hair and Nails A hair fiber is composed of a network of horny cells (hold your giggles, please) filled with hard protein called keratin. Hair growth is similar to the growth of the epidermal layer of the skin. Deep-lying cells in hair roots move forward through the hair follicles, or shafts, that hold the hair fiber. Melanocytes located at the root of hair follicles supply the melanin pigment for the hair fiber. Hair color depends on the amount of melanin present, as it does with the color of the skin. Because hormone production decreases as we get older, the hair loses color and becomes transparent (which we see as gray). Nails are hard keratin plates that cover the dorsal (top) surface of the last bone of each toe and finger. Nails are composed of horny cells that are cemented together and can extend indefinitely until cut or broken. A nail grows in thickness and length by division of the cells of the nerve root, at the base of the nail plate. Nails grow approximately 1 millimeter a week, which means that fingernails may regrow completely in three to five months. Toenails grow more slowly than fingernails, but if you have lost a toenail due to a nasty stubbing incident, it will come back eventually.