Podiatry Coding & Billing Alert

Question: My podiatrist’s notes indicate that a new patient with an injured foot had a foreign body removed from her heel. The podiatrist performed a subcutaneous foreign body removal (FBR) from the patient’s foot after a level-two evaluation and management (E/M) service. I originally thought I should report 10121, but another coder in my office said this was incorrect. Which code should I report?

California Subscriber

Answer: Although 10121 (Incision and removal of foreign body, subcutaneous tissues; complicated) is an FBR code, it is not the correct one in this case. CPT^® offers you specific codes just for FBR removal from the feet.

So, since the podiatrist’s notes indicate that the FBR removal from the foot was subcutaneous, you should report 28190 (Removal of foreign body, foot; subcutaneous).

Don’t miss: If your podiatrist performs a deep removal of a foreign body from the foot, you should report 28192 (Removal of foreign body, foot; deep). And, if the podiatrist performs a complicated removal of a foreign body from the foot, you would report 28193 (Removal of foreign body, foot; complicated).

You should also report 99202 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making … ) for the evaluation and management (E/M) code.

Modifier alert: You’ll need a modifier for 99202 to show that the E/M led to the FBR removal. The modifier you choose will depend on the foot FBR you go for. If it is a 28190 claim, append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to 99202, as the global period for the service is minor (10 days).

If, however, you choose to code 28192 or 28193, you’ll append modifier 57 (Decision for surgery) to the E/M, as the global periods for these services is major (90 days).