# foreign body removal from thumb without incision



## Deanine (Jun 5, 2014)

Hello, can anyone help with the following procedure? Dr. coded out a 20520 but is being denied for not being muscle or tendon and not having done an incision. Any insight would be appreciated. Thanks


I have done the following procedure.  After careful alcohol prep at the base of the left thumb, a total volume of 5 cc of 2% plain lidocaine and 5 cc of 0.25% plain Marcaine were injected using meticulous sterile technique as a metacarpal block.  Once the thumb had been appropriately anesthetized, the protruding limb of the staple volarly was grasped and the staple gently slid out of the finger.  This did not feel as if it had been embedded in bone as it did come out quite smoothly.  There was expected bleeding upon removal of the staple and the thumb was soaked for 10 minutes in dilute Betadine water solution.  The thumb was then dressed with Xeroform and gauze compression dressing secured with Coban.
Radiographs taken following the staple removal demonstrated an intact left thumb distal phalanx.  This was a soft tissue penetration only.


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## MarcusM (Jun 5, 2014)

I did not find a specific CPT for removal of foreign body from hand/fingers/thumb or of soft tissue...so this leads to E&M coding....other opinions?


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## cgreel (Jun 5, 2014)

CPT code 10120 would be appropriate IF he had made an incision. There is no other CPT code for the staple removal from soft tissue without an incision. You may code 64450 for the nerve block though.


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