20520 vs. 26070

kc-george

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I am having confusion regarding removal of a foreign body, and which code to use appropriately; can anyone help me? Is there something I should be looking for in particular? Below is the procedure note for removal of a FB on right thumb. Thanks.

PROCEDURE: The procedure was site marked in the holding area. Time-out was done on patient's entry into the room. Ancef 2 g was given within 1 hour of the incision. The right thumb was then prepped and draped in the usual sterile fashion. Incision was made over the entry site with knife used to dissect through skin and subcutaneous tissue. The eschar over the entry site was removed. We dissected down to the flexor tendon. He was noted have a splinter overlying the flexor tendon, which was removed.

We copiously irrigated, closed with Prolene, placed the patient in a bulky dressing, and he was taken to the recovery room in good condition. Sponge and needle counts were correct.
 

Amzie

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I would lean towards using 20520 because that is removal of foregin body in muscle or tendon sheath and the splinter was in the flexor tendon sheath and not in the joint.
26070 is an arthrotomy, which is in the joint and no incision was into the joint.
 
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