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.
This is a good point. The Doc could have just put a one sentence in the kids chart without a second thought and that triggered a billing admin to code it for maximum stupidity.
Or simply chose the relevant code that the insurance companies usually won’t deny.
They may not have even known the code computer charting can be challenging for some people and training is sparse.