ED Coding and Reimbursement Alert

Question: A patient presents to the ED with an abrasion and two small splinters in his left medial heel. According to the procedure note, the physician cleans the area with normal saline and infiltrates the area with 0.5 ml of xylocaine without epinephrine. Then, the physician uses a scalpel to cut a tiny 'x' over the injured area. Using an 18-gauge needle, she removes two bits of gravel and wraps the area with sterile gauze. How should I code this foreign body removal (FBR)? Maine Subscriber Answer: Code choice will depend on how deep the physician had to "dig" to remove the splinters. Go back and check the notes, or consult with the physician, and choose from the following codes: • 28190 -- Removal of foreign body, foot; subcutaneous • 28192 -- ... deep • 28193 -- ... complicated. No matter which code you choose, be sure to append 917.6 (Superficial injury of [...]