ED Coding and Reimbursement Alert

Question: A 47-year-old male reports to the ED complaining of a painful, swollen, and reddening right thumb. The physician performs an expanded problem focused history and examination, which uncovers two splinters. The ED physician cannot grasp the splinters with tweezers, so she uses a scalpel to make two small incisions above the splinters. The physician then uses tweezers to remove both pieces of wood. The notes do not indicate evidence of infection at the extraction site; medical decision making is low. Can I code this as a foreign body removal (FBR)?Kentucky SubscriberAnswer: Since the physician made an incision before removing the splinters, this is an FBR. On the claim, report the following:10120 (Incision and removal of foreign body,subcutaneous tissues; simple) for the FBR99282 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; [...]