Dermatology Coding Alert

Question: To bill for removal of a foreign body, the physician must perform an incision, right?

We had a patient with a fishing hook stuck in his foot. The physician wrote, "Cleansed with betadine, barb advanced and brought out, barb snipped off, rest of hook retracted." Can we report a foreign-body removal for this?


Washington Subscriber

Answer: Most foreign-body removals do require an incision, and depending on the method of removal, many fishhook retrievals involve an incision made by pushing the barb through another area of the skin to cut it off.

Your physician's note states, "barb advanced and brought out," which indicates that your physician pushed the tip of the fishhook out of the opposing side far enough to snip off the barb, thus creating an incision with the tip of the fishhook.

Even if you did need an incision to bill a foreign-body removal code, you have one, albeit with a fishhook.

If this scenario involved another area, like the hand, you could describe the physician's work with 10120 (Incision and removal of foreign body, subcutaneous tissues; simple).