Advanced Search

ED Coding and Reimbursement Alert

Reader Question:

Consult Code Book For Foreign Body Removals From the Foot.

Published on Mon Nov 21, 2011

Question: A patient with a splinter reported to the ED. After a level-two E/M, the physician uses a needle to make an incision and remove the splinter from the patient's right foot. The insurer rejected 10120 as mismatching the diagnosis. Should I appeal the denial?North Dakota SubscriberAnswer: The problem may have been a mismatch between the CPT® procedure code and the ICD-9 diagnoses code on the claim. Before sending in a claim for foreign body removal (FBR), make sure you have assigned the most specific code for the anatomical area treated. CPT® contains a specific code for a foreign body removal from the foot. You should have reported 28190 (Removal of foreign body, foot; subcutaneous) for the FBR rather than 10120 (Incision and removal of foreign body, subcutaneous tissues; simple). You should be able to refile the claim with the correct code.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

ED Coding and Reimbursement Alert

View All