ED Coding and Reimbursement Alert

You will need to report the same codes regardless of an incision If an ED patient has a foreign body removed from his person, you-ll likely be choosing between two codes: 10120 (Incision and removal of foreign body, sub-cutaneous tissues; simple) and 10121 (... complicated).
 
Exceptions: However, when coding a foreign-body removal (FBR) from a patient's foot, don't be fooled into reporting 10120 or 10121. Foot FBRs have separate code sets -- and you-ll report them slightly differently than other FBR codes, says Linda Martien, CPC, CPC-H, Coding Specialist for National Healing Inc. in Boca Raton, Fla.

Why? -The foot is not considered to be soft tissues- and therefore has a separate code set, Martien says.
 
The lowdown: Choose from these codes when reporting FBR from a foot:

 - 28190 -- Removal of foreign body, foot; subcutaneous
 - 28192 -- ... deep
 - 28193 -- ... complicated. Remember: Unlike other soft-tissue FBR codes, the CPT definitions for foot FBR do not require incisions. When your physician performs a foot FBR, report the above codes whether she made an incision or not.
 
If the location of the FBR is unclear, query your physician, because the foot FBR codes carry much higher relative value units than other FBR codes.