Podiatry Coding & Billing Alert

Question: Our clinic performed minor surgery on a patient to remove a metal fragment from the top of his right foot. I'm not sure which codes I should use but I'm thinking it might be a code in the 28020-28024 series. Can you help?

Georgia Subscriber

Answer: The code you'll report for this foreign body removal procedure will depend on where the fragment was. If your podiatrist surgically removed the metal fragment from the joints, the appropriate code would be one of the 28020-28024 series codes, depending on which joint the injury was closest to, as follows:

• 28020 -- Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint;

• 28022 -- ... metatarsophalangeal joint; and

• 28024 -- ... interphalangeal joint.

Alternative: If your podiatrist removed a fragment outside of the joint area, you may use any of the following codes, depending on the depth.

You should use 28190 (Removal of foreign body, foot; subcutaneous) if the foreign body was located just under the skin. If the foreign body is located beyond the skin, report 28192 (... deep). If your podiatrist needed to repair a torn tendon or nerves and the procedure required blood supply, report 28193 (... complicated).

Beware: Avoid using the general musculosketal foreign body removal codes 20520 (Removal of foreign body in muscle or tendon sheath; simple) and 20525 (... deep or complicated). CPT provides specific foreign body removal codes for the foot, so you should always use those as described above.