ED Coding and Reimbursement Alert

Question: A patient who had been hanging Christmas tree lights on his house all day reports to the ED with an irritated left eye. He says that one of the lights shattered while he was handling it, and he had been "wiping the eye out all day." The physician examines the eye area, and notes "undetermined particles and small foreign bodies, but cannot confirm glass ... could just be pieces of leaves or grass." Using saline irrigation, the physician cleans out the patient's eye and sends him home; no further tools are necessary. Is this an ocular foreign body removal (FBR), or is irrigation an E/M service? Colorado Subscriber Answer: This is a superficial conjunctival FBR, and it sounds as if an E/M also occurred. On the claim, report the following: • 65205 (Removal of foreign body, external eye; conjunctival superficial) for the FBR • an ED E/M code based [...]