While drilling one of the transosseous suture holes, during the procedure, a drill bit broke off inside the trochanter. The documentation indicates it seemed to be quite deep into the bone and was not retrievable; and as such, it was left in place.
The National Quality Forum (NQF) revised information on Serious Reportable Events in Healthcare. In Appendix A, on surgical or invasive procedure events, Event 1D Unintended retention of a foreign object in a patient after surgery or other invasive procedure currently excludes objects not present prior to surgery/procedure that are intentionally left in when the risk of removal exceeds the risk of retention (such as microneedles, broken screws).
In light of the NQF update, is code 998.4, Foreign body accidentally left during a procedure, still appropriate when the provider intentionally leaves a foreign body during surgery so that the patient is not subject to the added risk of removal?
Do not assign code 998.4, Foreign body accidentally left during a procedure, when the provider intentionally leaves a foreign body during surgery as to not subject the patient to the additional risk of removal. Assign instead code E871.0, Foreign object left in body during procedure, surgical operation, to show that there was a problem with a foreign body left during the procedure. The advice previously published in Coding Clinic is now being updated to reflect the NQF Update.