ED Coding and Reimbursement Alert

Survey says: Incision required for foot FBR. A girl limps into the ED with a splinter in the back heel of her foot. The nonphysician practitioner (NPP) takes a look at the injured area, and pulls the splinter out using tweezers. According to the code descriptors for foot foreign body removals (FBRs), you should be able to report 28190 for the encounter ... right? Not so fast: Many coders feel that even though the CPT descriptor excludes "incision," you should not report 28190 (Removal of foreign body, foot; subcutaneous) unless the provider makes an incision. Be Safe: Apply Soft-Tissue Incision Rules While the descriptors might appear to "justify the assignment of 28190-28193 if no incision is made, CPT guidelines consider that a non-invasive procedure and will not warrant any additional coding besides the E/M," says Pamela Cline, RHIT, senior coding supervisor for Medical Account Services in Frederick, Md. In short: [...]