Tag Archives: laceration
Posted on 17. Jan, 2010 by sanjay.aikat.
Question: A 60-year-old patient reports to the ED with a bandaged left hand. The patient says she was cleaning out the blades of her snow blower and cut her left index finger; the wound is wrapped in gauze, but it is reddening with blood. During an expanded problem focused history and exam, the physician undresses the wound, applies pressure and ice to stop the bleeding, and cleans it using Betadine. During the E/M service, the physician notes a laceration to the index finger but no signs of infection. Using Dermabond, the physician closes a 2.7 cm laceration on the patient’s finger. How should I code this encounter?
Posted on 17. Aug, 2009 by .
Question: The dermatologist treated an established patient with a cut on her lip and used Dermabond to close the 1.8-cm laceration. Should I use a laceration repair code when the only adhesive he used was Dermabond?
Answer: Your code choice will depend on the patient’s insurance. Check out these two coding options:
Patient has Medicare: If the physician uses Dermabond as the only closure material for a simple repair on a Medicare patient, report G0168 (Wound closure utilizing tissue adhesive[s] only) for the service.
Patient has commercial insurance: If the commercial carrier follows Medicare rules, use G0168. However, if the payer does not observe Medicare guidelines, you’ll most likely choose a laceration repair code, even when Dermabond is the only adhesive the physician uses. On the claim, report 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).
Either way: Append 873.43 (Other open wound of head; face, without mention of complication; lip) to the procedure code to represent the patient’s injury.
Posted on 03. Aug, 2009 by .
If you pigeonhole encounters involving suture removal as 99212s, you could be cutting yourself short — or possibly overcharging your service. To tell whether you need to code more or less for laceration follow-up care, answer these 5 questions.
1: Did Your Physician Complete the Repair?
Yes: If your dermatologist or a physician within your group places the sutures, you shouldn’t bill for their removal, confirms Tracy Russell, CBCS, a coder in Westminster, Md. The laceration repair code includes uncomplicated, related postoperative follow-up visits and suture removal.
No: If another physician places the sutures and your dermatologist removes them, you can bill for the wound check and removal.
2: Are You Providing a 2-Day Post-ER Check?
Physicians are sometimes called upon to evaluate wounds a couple of days after the hospital’s Emergency Room staff completes laceration repairs.
Posted on 29. Jun, 2009 by .
Patients often report to the ED with multiple lacerations — and coding will vary depending on several factors.
Remember: “The location and type of closure will tell you whether to add [the repairs] together or use separate codes,” says Kevin Arnold, CPC, business manager for the Emergency Medicine Department at Connecticut’s Norwalk Hospital. Check out these brief case studies so you can cut to the quick when coding more than one laceration fix on the same patient.
Case 1: Cuts of the Same Severity, Location
The first step in coding multi-laceration repairs is to “look to the type of closures; if they are the same type … and both repairs are located in the same anatomical location, then you would add them together,” explains Arnold.
For example, the ED physician performs a 2.1 cm intermediate repair on a patient’s left ear, and an intermediate 3.4 cm repair on her left cheek.
In this instance, you would add the repair lengths (2.1 + 3.4 = 5.5) and choose 12053 (Repair, intermediate, wounds of face, ears, eyelids, nose, lips, and/or mucous membranes; 5.1 cm to 7.5 cm) for the encounter.
Case 2: Cuts of Differing Severity, Same Locale
If the patient has lacerations in the same anatomical grouping, but the severity differs, report a code for each repair, Arnold confirms. For example, the ED physician performs intermediate repair of a 2.3 cm cut on a patient’s right shoulder, and a simple repair of a 3.4 cm laceration on the patient’s lower back.
In this instance, you would report the following:
Posted on 05. Jan, 2009 by .
Question: A pediatrician uses Dermabond to close a patient’s 1.0-cm cheek laceration. Should you assign a laceration procedure code and a Dermabond code?
Answer: You should use the same CPT codes for closing a laceration with Dermabond as you do for suture repair. Report the appropriate simple repair code and open wound diagnosis. The repair codes’ practice expense relative value units include the Dermabond supply, which you should not bill separately.
Using the CMS-1500 form, you should code your case as follows:
• in box 21, enter 873.41 (Other open wound of head; face, without mention of complication; cheek)
• in box 24-D, report 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).
For repair of nonfacial wounds involving Dermabond, you should instead use 12001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less).
Got more questions on skin repair coding? Get some advice from expert John Verhovshek. [