Follow This Advice to Extract Maximum FBR Benefit
'FBR' encounter could be an E/M, a procedure ... or both.
Maybe. You cannot report an FBR code each time the physician removes a soft-tissue FB. Automatically choosing one without considering it in the context of the encounter could quickly land your practice in hot water.
Who ya gonna call?
Check out this installment of "Mythbusters" and you won't have to work overtime to identify proper coding for each FBR encounter.Myth:Tweezer/Forcep Use Means FBR Code
Actually, these encounters will almost always end up being E/M services, explains Cheryl Starner, CPC, revenue integrity analyst for Missouri's Truman Medical Centers headquartered in Kansas City."If the FB is removed [only] with forceps, tweezers, or any other non-incising instrument, then the procedure is bundled in the E/M," says Starner.
Example:
An established patient reports to the internist for examination of a painful, swollen, and reddening right thumb. The internist performs a problem focused history and examination, which uncovers two splinters. The internist uses tweezers to remove both pieces of wood. There is no infection present at the extraction site.This is an E/M service, even though an FBR technically occurred. On the claim, report 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making ...) with 915.6 (Superficial injury of finger[s]; superficial foreign body [splinter] without major open wound and without mention of infection) appended to represent the patient's injury.
Myth: If FB's in Deep, Choose FBR Code
Not necessarily. It's the "incision decision" that drives code choice when the internist removes an FB. If the internist makes an incision during the removal, report an FBR code, confirms Kevin Solinsky, CPC, CPC-I, CPCED, president and CEO of Healthcare Coding Consultants LLC, Added Value Billing Inc. in Gilbert, Az. For soft-tissue FBRs, report either 10120 (Incision and removal of foreign body, subcutaneous tissues; simple) or, rarely, 10121 (... complicated).
