ED Coding and Reimbursement Alert

Question: A patient reports to the ED with a sprained left ring finger; the digit is swollen enough that the physician decides the patient's wedding band must come off to prevent further injury. Using a portable saw, the ED physician removes the ring, instructs the patient on how to care for the sprain and sends him home. What diagnosis codes should I use for this scenario, and is there a CPT code for ring removal via saw?

Tennessee Subscriber

Answer: There is no procedure code for saw use during a ring removal; therefore, report the appropriatelevel ED E/M based on the notes (99281-99285).

Dx coding: Report 915.8 (Superficial injury of finger[s]; other and unspecified superficial injury of fingers without mention of infection) for the injury and E928.5 (External constriction caused by other object) to represent the cause of the injury.