Correct code for splinter removal

I agree with Dr. Kesselman, you removed superficial foreign body the correct procedure is CPT 10120, it is important to bill what you do. If there was an E/M that was distinct and separate then that is 99213-25. Billing is based on what you do and not the reimbursement!

If you base your billing only on the fee schedule, without regards to what you actually performed, than , I fear that you may be making a huge mistake. You should be billing for what you did and not for what pays more or to circumvent the medical policies. In this case you performed a simple splinter removal, its location does not matter. This scenario applies to any physician removing a splinter from any location. If the removal was simple, no local, no sutures, no sophisticated bandaging, etc. then CPT 10120 is appropriate.

As for looking at the fee schedule, I am not sure how you came up with the idea that an E/M for an established patient paid more than for a simple splinter removal. The fee schedule for Queens NY for Fee for Service Medicare is as follows:

10120: $178.64; 99212: $65.13 99213 $103.68

If it were a new patient the E/M are: 99202: $83.01 99203: $127.76

If it were in fact a new patient, it may also be possible to submit a claim for the E/M depending on what is documented in the chart regarding the Medical Decision Making complexity. This would depend on a lot of other factors. I am sure others more skilled in billing E/M may choose to chime in on this, but regardless, I don't see that the E/M pays more than a simple splinter removal. Thus, I am unsure where that idea came from.