CPT code 10120 is a medical billing code used to describe the procedure of removing a foreign body from a patient.
CPT code 10120 is used to describe the procedure for removing a foreign body from a patient's skin or subcutaneous tissue. This code is typically utilized when a healthcare provider needs to extract an object that has penetrated the skin, such as a splinter, piece of glass, or other debris, to prevent infection or further complications. The procedure involves making an incision to access and remove the foreign material safely.
When using CPT code 10120 for the removal of a foreign body, the following modifiers may be applicable:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the removal of the foreign body required significantly more effort or time than usual.
2. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: Apply this modifier if an unrelated E/M service is performed during the postoperative period of another procedure.
3. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service: Use this modifier if a significant, separately identifiable E/M service is provided on the same day as the procedure.
4. Modifier 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both sides of the body.
5. Modifier 51 - Multiple Procedures: Apply this modifier if multiple procedures are performed during the same surgical session.
6. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
7. Modifier 53 - Discontinued Procedure: Apply this modifier if the procedure was started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
8. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the procedure was distinct or independent from other services performed on the same day.
9. Modifier 76 - Repeat Procedure or Service by Same Physician: Apply this modifier if the same procedure is repeated by the same physician.
10. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the same procedure is repeated by a different physician.
11. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Apply this modifier if the patient returns to the operating room for a related procedure during the postoperative period.
12. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of another procedure.
13. Modifier 80 - Assistant Surgeon: Apply this modifier if an assistant surgeon is required for the procedure.
14. Modifier 81 - Minimum Assistant Surgeon: Use this modifier if a minimum assistant surgeon is required for the procedure.
15. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Apply this modifier if an assistant surgeon is required and a qualified resident surgeon is not available.
16. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant at surgery: Use this modifier if a PA, NP, or CNS assists in the surgery.
Each modifier serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 10120 is reimbursed by Medicare, but the reimbursement is subject to specific guidelines and conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates.
Additionally, the reimbursement for CPT code 10120 may vary depending on the local policies and determinations made by the Medicare Administrative Contractor (MAC) for the region in which the service is provided. It is essential for healthcare providers to consult the MPFS and their respective MAC to ensure compliance with Medicare's billing and reimbursement requirements for this specific CPT code.
Discover the power of MD Clarity's RevFind software to ensure you're getting paid what you deserve. With RevFind, you can read your contracts and detect underpayments down to the CPT code level, including specific codes like 10120. Schedule a demo today to see how RevFind can help you identify and address payment discrepancies by individual payer.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
