Internal Medicine Coding Alert

Once ICD-10 goes into effect, check the type of retained body.

Choosing your primary diagnosis code for foreign body removal (FBR) will stay the same in some regards when ICD-10 goes into effect. For example, the ICD-9 code 709.4 (Foreign body granuloma of skin and subcutaneous tissue) makes an easy shift under ICD-10 to L92.3 (Foreign body granuloma of the skin and subcutaneous tissue). You might need to add one more code, however, to have a complete claim beginning in Oct. 2013.

Here's why: Coding notes with ICD-10 sometimes instruct you to "Use additional code to identify the type of retained foreign body (Z18-)." Prior to 2011, you didn't have any additional codes to report for FBR. The 2011 version of ICD-9 includes a new text note stating, "Use additional code to identify foreign body." ICD-9 added 14 new V codes for foreign body removal that parallel what you'll see in ICD-10.

Here are the ICD-9 and ICD-10 codes identifying retained foreign bodies. Notice they represent a one-to-one crosswalk listed with identical code descriptors from ICD-9 to ICD-10.

ICD-10 includes a wide range of diagnoses for foreign body removal based on the type of FB, anatomic location, and extent of associated wound. You'll need to carefully study the options in the index before choosing the most appropriate diagnosis.

The associated notes will direct you regarding choosing a code for the type of retained body.