Health Information Management

Q&A: Coding the removal of dentures lodged in a patient’s oropharynx

JustCoding News: Outpatient, February 24, 2010

Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Outpatient!

QUESTION: A patient came to the ED after she swallowed her dentures and they became lodged in her oropharynx.

Using a tongue depressor, the physician was able to see her dentures stuck in the back of her throat in her oropharynx, partially down into her esophagus in a vertical position. The physician was then able to reach back in the patient’s mouth with his or her hands and forcibly remove the dentures.

Is it correct to report the following codes?

  • 933.0 (Foreign body in pharynx)
  • E849.0 (Place of occurrence; home) 
  • E915 (Foreign body accidentally entering other orifice)
  • 98.13 (Removal of intraluminal foreign body from pharynx without incision)

ANSWER: I agree with your reporting codes 933.0 and E849.0. However, code E915 (Foreign body accidentally entering other orifice) has an “excludes” note that leads me to code E912 (Inhalation and ingestion of other object causing obstruction of respiratory tract—obstruction of pharynx by foreign body), which, from the information provided, appears to be a more accurate code.

For that reason, code 98.13 (Removal of intraluminal foreign body from pharynx without incision) is probably inaccurate. In addition, the term intraluminal means within the lumen of a tubular structure. This does not properly describe a denture. Therefore, if you are going to report an ICD-9-CM procedure code, I would suggest code 98.22 (Removal of other foreign body without incision from head and neck).

Finally, are you certain the third-party payer wants you to report ICD-9-CM volume 3 procedure codes for procedures performed in the ED? The ED is considered an outpatient facility; therefore coders typically report CPT codes for services provided to patients who have not been ultimately admitted into the hospital.

For this reason, a CPT code—in this case, code 42809 (Removal of foreign body from pharynx)—is most likely the appropriate choice.

Editor’s note: Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, FL, answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, WI. E-mail her at ssafian@embarqmail.com.

This answer was provided based on limited information submitted to JustCoding.com. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.



Want to receive articles like this one in your inbox? Subscribe to JustCoding News: Outpatient!

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular