ED Coding and Reimbursement Alert

Beware: Fluid evacuation bundled into most other toenail procedures. Barefoot summer days are supposed to salve the soul, but they often end in ED presentations for foot injuries. Check out these case studies for clues on coding common ED foot procedures. Case: Drilling to Treat Crushed Toe Patients who report to the ED with toe crush injuries might require trephination to release blood (or fluid) from beneath the nail. When the ED physician performs only trephination, report 11740 (Evacuation of subungal hematoma) for the encounter, confirms John F. Bishop, PA-C, CPC, president of Bishop & Associates Inc. in Tampa, Fla. Example: A patient reports to the ED with a badly bruised right great toe; there is a buildup of blood and pus beneath the nail. Using a small needle, the physician bores a hole in the nail to relieve pressure and drain fluid. In this instance, report 11740 with 924.3 [...]