tci ED Coding & Reimbursement Alert - 2015 Issue 1

Reader Question: Watch Your Step When Coding For Foreign Body Removals From the Foot

Question: A patient with a splinter reported to the ED after walking barefoot on an old wooden porch. After a level-two E/M, the physician uses a needle to make an incision and remove the splinter from deep within the patient’s right foot. The insurer rejected 10120 as mismatching the diagnosis. Should I appeal the denial?  California Subscriber Answer: The problem may have been a mismatch between the CPT® procedure code and the ICD-9 diagnoses code on the claim. Before sending in a claim for foreign body removal (FBR), make sure you have assigned the most specific code...

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