Wiki CPT 28190 Splinter/FB removal

[Jennercoder]

Hi Everyone:

I have someone in my billing dept. that's wondering if it's OK for us to use this code 5 times, for 5 splinters...

My thinking is that it's OK...? Please advise, and thanks in advance.

 

[jdibble]

Before I would say how many times you could use the code I would ask how were these splinters removed? The despcription of the procedure is:

Foot is prepped and draped in the usual sterile fashion. Anesthesia is obtained by injection of local anesthetic as a regional block to the surgical site. Skin is incised from the dermis to explore the foreign body embedded in the subcutaneous tissue, which is removed by scalpel. Wound is then irrigated with an antiseptic solution and closed in layers with sutures or Steri?strips.

If each of these were not removed by making an incision and going into the subcutaneous tissue, then you wouldn't use 28190 for the splinter removals and would just bill the E/M. If the physician did do this 5x and they were separate incisions, then I would code 28190 for each with a 59 modifier for the additional codes.

 

[DeLisa_Smith]

See CPT Assistant, December 2013, Volume 23, Issue 12, page 16; it explains the difference between 10120 and 28190 based on depth of foreign body; 10120 being incision made into skin and subcutaneous; 28190 "If the fascia was penetrated and the foreign body was within the fascia, subfascial, or muscle, then the Musculoskeletal series of codes would be reported."