Primary Care Coding Alert

Squeeze these V90 retained fragment codes onto fall tickets.

When you can't get all of a splinter out, a new diagnosis code series will soon tell the story. FPs are all too familiar with foreign body removal that gets only part of the object -- and come this fall they'll have a diagnosis code that explains the condition.

Pieces of wood, glass, or bullet shrapnel might be left in during foreign body removal. The fragment may break or split, making removing the entire foreign body impossible.

This condition has stumped many a family physician. Sometimes, with a wood splinter removal, the procedure removes some foreign body, but not all of it, related one Atlanta FP. Is the FBR ICD-9 code still appropriate? In the event, the patient had further FBR done at another encounter, would using the FBR diagnosis at the initial FBR encounter mean future claims using the same ICD-9 code would be denied?

Add These V90 Codes to Your Diagnosis Charge Ticket

ICD-9 2011 solves both dilemmas. Effective Oct. 1, 2010, you can indicate a foreign body was partially removed. You can even indicate a follow-up check for infection after complete removal with a new code for personal history of retained foreign body fully removed (V15.53).

Check out the below list for fragment codes you should squeeze onto your super bill. FPs might use ICD-9 codes for retained fragments of:

• Animal quills or spines           V90.31
• Glass                                   V90.81
• Metal, magnetic                    V90.11
• Metal, nonmagnetic               V90.12
• Metal, unspecified                 V90.10
• Other organic                       V90.39
• Other specified                     V90.89
• Plastic                                 V90.2
• Stone or crystalline               V90.83
• Unspecified                           V90.9
• Wood                                   V90.33