Part B Insider (Multispecialty) Coding Alert
Don't Turn Your Nose Up at These FBR Codes
Question: A patient reports to the emergency department (ED) with a crayon stuck in his left nostril. The physician performs an expanded problem focused history and exam, noting the airway patency; she then performs a lung exam to evaluate for aspiration and wheezing. The physician removes the crayon using small forceps. Is this an ED E/M service, or does this work warrant a procedure code? Answer:
30300 (Removal foreign body, intranasal; office type procedure) for the foreign body removal (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 E/M
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
932 (Foreign body in nose) appended to 30300 and 99282 to represent the FB.
Part B Insider (Multispecialty) Coding Alert
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