# cactus needles



## survivor1 (Jul 12, 2012)

Pt presented with numerous cactus needles to be removed.  Do I use a regular E&M code for the proceedure with a 22 modifier?  The definitions for removal don't really fit.  I'm not sure for dx to use wound or not.  Anyone have some answers for me?


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## FTessaBartels (Jul 16, 2012)

*22 modifier - NOT*

You cannot use a -22 modifier on an E/M code.

Unless some incision was required .... or the patient had to be taken to the OR for general anesthesia (which happened just last week for one of our patients who was too young to sit still for the procedure) ... you will only be able to code the E/M.   Physician should document the total amount of time spent, because you'll probably be able to use the the Prolonged Services code as well.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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