Pediatric Coding Alert

Question: What would be the best code to use when a patient comes into the office with a ring stuck on her finger? The doctor came in and briefly looked at the patient’s finger, and the nurse then used a cutting tool to cut the ring. The doctor wants to use 10120, but as there was no incision, I am arguing that code is not appropriate. How should I code this encounter?

AAPC Forum Participant

Answer: You are correct in thinking that 10120 (Incision and removal of foreign body, subcutaneous tissues; simple) does not describe the process by which your nurse removed the ring from the patient’s finger. The code implies that the foreign body was embedded below the upper layer of the patient’s skin, that the provider made an incision in the patient’s skin with a sharp instrument such as a scalpel, and the foreign body was removed from the tissue with forceps or a similar instrument. This does not reflect your description of the encounter.

Instead, an office/outpatient evaluation and management (E/M) code from 99202-99215 (Office or other outpatient visit for the evaluation and management of a new/established patient …) is the best way to capture the work involved in the ring removal. Given the number and complexity of the problem addressed (one self-limited or minor problem), and the minimal risk of complications or morbidity to the patient from the nurse’s cutting the ring off the patient’s finger, the most likely service level for this would 99202/99212 (Office or other outpatient visit for the evaluation and management of a new/established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making …).