# Does 28190 require an incision?



## missmeeka85 (Aug 2, 2017)

Hi there,

As the title says - does CPT 28190 - "removal of foreign body, foot subcutaneous" require an incision?  The CPT book doesn't say incision and removal like 10120 - incision and removal of FB.  I am reading conflicting information online.  If you say it DOES require an incision, could you please cite a source to back that up?

Thanks!


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## Ritika (Aug 3, 2017)

*28190*

I guess that 28190 is excluded of incision, so we would not report 28190 unless incision is not mentioned.


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## hblakeman (Aug 3, 2017)

*No, no incision required*

According to the coding companion, use 28190 when the foreign body is located beneath the skin in the sub-q tissue... An incision may be made, and wound irrigated and closed if applicable.


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## missmeeka85 (Aug 3, 2017)

hblakeman said:


> According to the coding companion, use 28190 when the foreign body is located beneath the skin in the sub-q tissue... An incision may be made, and wound irrigated and closed if applicable.



Thank you.  So when it says "incision may be made" does that mean it MUST be made?


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## hblakeman (Aug 4, 2017)

No, "may" means one could be made or not.  If one has to be made it will say something like: an incision IS made, or the physician MAKES an incision, or the physician INCISES.  Coding is so detailed, you have to take every word into consideration.  From the code description to the provider's documentation, one word can make a huge difference.


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## missmeeka85 (Aug 4, 2017)

Thank you  that is what I thought.  I had just read online that it did require an incision.  But since the code itself didn't say - I felt that it did not.  I appreciate your help!!  And yes, one word can make a HUGE difference!


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## DeLisa_Smith (Aug 2, 2019)

See _CPT Assistant_, December 2013, Volume 23, Issue 12, page 16; it explains the difference between 10120 and 28190 based on depth of foreign body; 10120 being incision made into skin and subcutaneous; 28190 "If the fascia was penetrated and the foreign body was within the fascia, subfascial, or muscle, then the Musculoskeletal series of codes would be reported."


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## wendy.moore@honorhealth.com (Sep 13, 2019)

DeLisa_Smith said:


> See _CPT Assistant_, December 2013, Volume 23, Issue 12, page 16; it explains the difference between 10120 and 28190 based on depth of foreign body; 10120 being incision made into skin and subcutaneous; 28190 "If the fascia was penetrated and the foreign body was within the fascia, subfascial, or muscle, then the Musculoskeletal series of codes would be reported."


I am working on a case very similar to this. but according to what I have read 28190 is subcutaneous, as there is 28192/28193 for deep/complicated. 
here is the description from 3M. 

A foreign body located within the tissue of the foot is removed and the wound is irrigated and closed, if applicable. A dressing is applied and aftercare may include antibiotic injection into the wound and/or orally. Weight bearing is allowed as the wound heals. Report 28190 if the foreign body is located beneath the skin in the subcutaneous tissue. Report 28192 if the foreign body lies deeper in the foot below the subcutaneous layer.

It seems these 2 codes are used for an open wound, but I guess that is open to interpretation.


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