ED Coding and Reimbursement Alert

Question: I recently had a chart with a machine shop worker complaining of left eye pain after a small piece of metal hit him in the eye while polishing metal pieces. Our emergency physician examined the affected area, and then used a burr to scrape the corneal epithelium area clean of the “rust ring.” How do I report the rust ring removal: Should I report this as a foreign body removal?

Maryland Subscriber

Answer: While the ring is technically a foreign body, payers do not consider rust ring removal a foreign body removal for coding purposes, and therefore you cannot code 65220-65222 (Removal of foreign body, external eye …) for this encounter. Instead report the service with 65435 (Removal of corneal epithelium; with or without chemocauterization [abrasion, curettage]) for the rust ring removal.