Simple Laceration Repair Code or E/M Code? Answer Could Cost Hundreds
Posted on 31. Mar, 2009 by Editor in Hot Coding Topics
Not recognizing a laceration repair that’s included in an E/M won’t cost you anything, but identifying a separately countable one could add $100 or more to your bottom line.
You’ll be able to spot E/M-repair code combo scenarios, and optimize rightful reimbursement, with this expert advice.
Materials Matter When IDing E/M Fixes
Your ED physician will treat a lot of patients with lacerations; some will be E/M services, and some will be simple fixes, which CPT represents with 12001-12021.
“An average of one in 15 emergency patients receives some form of wound care,” says James Blakeman, senior vice president at Emergency Groups Office in Arcadia, Calif. This means that every ED, regardless of location, is going to see its share of laceration repair claims.
You can commit coding missteps if you just assume every laceration fix the ED performs is a procedure. If the physician uses steri-strips or some other adhesive strip you should consider the work part of the overall E/M level.
“Most steri-strip applications are done by nursing staff; but even if the physician applies them, they are included in the E/M service,” says Kevin Solinsky, CPC, CPC-I, CPC-ED, president and CEO of Healthcare Coding Consultants LLC, Added Value Billing Inc.
Example: A patient reports to the ED with a laceration to his right forearm. After performing an expanded problem-focused history and exam, the ED physician decides that the wound is very superficial. He closes the 3.5 cm cut using steri-strips and directs the patient to follow up with his primary care physician should any complications arise.
In this instance, the closure material dictates that you should code only for...
If you've already signed in and are still seeing this screen, click here to refresh the page.
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers
Loading ...