General Surgery Coding Alert
24200, 23330: Anatomy Solves FBR Denial
Question: Our surgeon used a scalpel and tweezers to perform complicated splinter removal on a patient's left shoulder (880.10) in the emergency department. Notes indicate that the subcutaneous removal was preceded by a level-two E/M service. I reported 24200 and 99282 and received a denial. What did I do wrong? Washington Subscriber Answer: You should have chosen a more accurate code for the foreign body removal (FBR). Based on the diagnosis code (880.10, Open wound of shoulder and upper arm; complicated, shoulder region) you should not use 24200 for this procedure. Also, you'll need a modifier to report the procedure and E/M together. When you re-submit the claim, report the following: 23330 (Removal of foreign body, shoulder; subcutaneous) for the FBR 99282 (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; and medical decision making of low complexity ....) for the ED E/M service modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to 99282 to show that the E/M and the FBR were separate services Explanation:
General Surgery Coding Alert
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24200, 23330: Anatomy Solves FBR Denial
Question:Our surgeon used a scalpel and tweezers to perform complicated splinter removal on a patient's [...]
