subject: Internal medicine coding: 5 Principles to help your FBR coding [print this page] If you automatically look to 10120 when an internist removes a tick, splinter or other foreign body from a patient's foot, you could be losing almost $100 per claim.
Better: You will not shortchange your doctors on foreign body removal provided you toe these guidelines.
Before using 10120, check for incision
Do not assume foreign body removal is a shoe-in for CPT integumentary section code 10120; the code calls for incision. This can be, for instance, a needle to remove a splinter or a scalpel to remove a glass shard.
Hint: When considering 10120, look for a sharp object. If the documentation does not include this detail, report an E/M service code instead of the skin FBR code.
Rule out site-specific code using two details
CPT contains higher paying site-specific codes for foreign body removed from the musculoskeletal area and anatomic system sections. To see if the removal qualifies for a site-specific code, here are two details:
Location: Minus information about the removal's location, you have got to use one of the skin FBR codes (10120 or 10121) provided the documentation also meets the procedure code's incision requirement.
Depth: While coding or auditing, look in the notes for the term fascia'. If the notes indicate above fascia or make no mention of fascia, go for the integumentary code. If the note says through fascia or into the muscle, then I go to the 20,000 series.
Quickly find site specific code using these options
Since CPT places the anatomic FBR codes in the corresponsing system section, finding a site-specific FBR code can be like looking for a needle in a haystack. You can locate a site-specific code easily using one of these methods:
Manual, electronically.
ID site specific complexity
You will notice that under the integumentary and anatomic FBR codes, CPT offers options for the removal's difficulty. Many FBR code families include a simple and then a complicated code like 10120 and 10121.
Typically internists carry out FBRs. But, your internal medicine, especially if it offers urgent care may encounter FBRs that are complicated.
