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Exploration of extremity wound

  1. #1
    Adirondack Chapter of Professional Coders, Glens Falls, NY
    Default Exploration of extremity wound
    Medical Coding Books
    I have coded 20103 for the exploration of a penetrating finger wound in the emergency room and the special investigations department at the insurance company called me and told me I cannot bill for the exploration of the finger because the finger is not an extremity. Is this true?

  2. Default
    The upper extremity does include the hand/fingers. However, sometimes payers base their rationale to deny a code based on the work performed. If they have determined that a different code should have been billed, they will not tell you that, nor will they assist you with what code to bill [ie. a code with lesser RVUs]. Could you post the op report so that we may review?

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