# Foreign Body Removal - tick left behind



## Lorisvg (Jun 12, 2008)

We had a patient come in with remnants of a tick left behind.
The MD froze the area, and with a needle removed the top of a scab, and 2 small remaining tick parts were removed. He then used Drysol to stop a spot of bleeding. Would you code this with 10120?
Thanks for your help!


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## mbort (Jun 12, 2008)

Two questions:  Did he truly make an incision?  Did he go down to the subcutaneous tissue?

I'm thinking the answer is probably no which may leave you with just an E/M code but I could be wrong.

Did he debride the area?  If so, then perhaps you could use a debridement code.

Anyone else with any thoughts on this?


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## Lorisvg (Jun 12, 2008)

He didn't debride the area, and he didn't make an incision exactly. He removed the top of the scab with a needle, and doesn't say how he reoved the tick parts. It was once explained to me, that the act of the foreign body piercing the skin can also count as the incision. I have always been suspicious of that rationale. Thoughts anyone?


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## daniel (Jun 12, 2008)

I see where your trying to go with this one. And judging off what you wrote, you might think like me. Always trying to push the envelope, and get the most for your physician. Within compliance of course.

But on this case, looks like I would just code this bundle with the E/M. Your pushing it, trying to get a Incision & Removal of Foreign Body CPT out of this.


Respectfully

Daniel
CPC


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## Erica1217 (Jun 12, 2008)

If documentation doesn't specifically say an incision was made, then I would bill the E&M code only. 

 Erica


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## LOVE2CODE (Jun 13, 2008)

Erica1217 said:


> If documentation doesn't specifically say an incision was made, then I would bill the E&M code only.
> 
> Erica




I agree w/Erica.....If it is NOT DOCUMENTED-it was not done....


YTH,CPC


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## dmaec (Jun 16, 2008)

it doesn't sound like a foreign body removal to me.  I think it should be billed out as an E/M level only.


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## smwermter (Jun 25, 2008)

I live in Minnesota and we see TONS of tick bites and tick removals with a needle and we just code the E&M level unless the physician *specifically **documents *that the skin was incised.  Glad to see others agree because I have often questioned if I should be coding the removal.  Thanks!


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