Normally, complex foreign body removals don't present in the ER, however if the physician does wind up doing a complicated soft-tissue FBR, you may be able to increase your revenue for the service. If you get a medical billing claim to process for this procedure, you should code the service with 10121 (Incision and removal of foreign body, subcutaneous tissues; complicated).

There are a few things to look for when making the determination if you have a simple or complex FBR. A complex soft-tissue FBR may also involve localization techniques with a C-arm fluoroscopy device, ultrasound, or x-rays with radiographic markers and extensive dissection.

This can also occur when the FB itself isn't necessarily complex however the object couldn't be initially located and something could be palpitated beneath the skin, however attempts to locate the FB fail. Using C-arm fluoroscopy guidance may be necessary and for most carriers, this will meet a basic need for being considered a complex FBR procedure.

Make sure you attach the correct modifier and if you go with a complex claim, make sure to show the failed attempts that led to the elevated procedure to remove the FB.
Using these tips, you should be able to break out from partial payments and realize better revenue reimbursements on your more complex foreign body removal medical billing claims.

Labels: claims, medical-billing, medical-coding, modifiers, outsourcing