ED Coding and Reimbursement Alert

Question: The physician removed an embedded fish hook by cutting the barb with wire cutters and pulling it out with forceps. Should I use the foreign-body removal code 10120? Does the physician have to make an incision for the procedure code to count?

Utah Subscriber

Answer: According to CPT, use 10120 (Incision and removal of foreign body, subcutaneous tissues; simple). In situations like this -- in which the foreign body has created an "incision" of sorts - not every practice has the same philosophy about which code to report. Some practices consider the incision to be made by the fish hook, and others consider only the physician's work with the scalpel blade to be an incision.

You should discuss with your physician group their philosophy about what they count as "incisions." But do note that most fish hooks, when embedded in flesh, require some dissection in order for the doctor to free up the individual barbs and allow removal, so the physician often needs to make small cuts during the procedure.

For more extensive foreign-body removals, you should report code 10121 (... complicated).