When George Lai of Portland, Oregon, took his toddler son to a pediatrician last summer for a checkup, the doctor noticed a little splinter in the child’s palm. “He must have gotten it between the front door and the car,” Lai later recalled, and the child wasn’t complaining. The doctor grabbed a pair of forceps — aka tweezers — and pulled out the splinter in “a second,” Lai said. That brief tug was transformed into a surgical billing code: Current Procedural Terminology (CPT) code 10120, “incision and removal of a foreign body, subcutaneous” — at a cost of $414.
Are y’all saying that it should have been done for free, in the system we are currently in? What should have been the CPT? That is, unfortunately, the most correct coding there is for that. Should there be a lesser code? It is easy to argue there should be. But, to chart otherwise is considered fraud.
Also, the charges are ‘fake’ anyway, as it is a stupid game that is played to get insurances to actually pay anything.