CPT Knowledgebase - Dec 20, 2013

The patient stepped on a cactus and had a number of cactus spines in his foot. The physician removed the spines from several areas of the toes, and bottom of the foot. The spines, which were approximately 2 mm in length and located in the skin and subcutaneous tissue, were removed with tweezers and some required a small incision for removal. The fascia was not penetrated. The patient was uncooperative, and it took about 20 minutes to remove all the spines. Would this be reported with several units of code 28190, Removal of foreign body, foot; subcutaneous, and code 28192, Removal of foreign body, foot; deep? Or may we report the Prolonged Services codes for the extra time and effort involved?

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