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Primary Care Coding Alert

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Coders Disagree on Foot FBR Specifics

Published on Tue May 26, 2009

Question: A 43-year-old established patient meets the FP at the hospital with an injured foot; he had been repairing a shed in his bare feet, and stepped on a carpentry nail with his left foot. The FP removes the subcutaneous foreign body from the patients left heel, but she does not make an incision. Is this considered a foreign body removal (FBR)? Florida Subscriber Answer: It depends on who you ask. According to Cheryl Starner, CPC, revenue integrity analyst for Missouris Truman Medical Centers, you can report 28190 (Removal of foreign body, foot; subcutaneous). Reasoning: The 28190 code makes no mention of an incision. This code descriptor differs from CPT definitions for soft-tissue FBRs (10120-10121, Incision and removal of foreign body, subcutaneous tissues &), which specifically mention incision. There are also coders, however, who feel FBRs without incisions are not FBRs at all, but E/M services. Reasoning: Even though the [...]
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