ED Coding and Reimbursement Alert

Accounting for depth is a tricky task when coding closure. Practices interested in $80 or more for the same closure repair need to walk the line that separates simple from intermediate. Check out part II of our wound care FAQ for all the facts on ferreting out those higher-paying intermediate repairs. What Makes a Repair "Simple"? A wound closure is a simple repair if the procedure: • is simple; • is a single-layer closure involving the epidermis, dermis, or subcutaneous tissues; and • does not involve deeper structures. Code these closures with 12001-12021, confirms Dilsia Santiago, CCS, CCS-P, a coder in Reading, Pa. And remember that simple repair includes "local anesthesia, and chemical or electrocauterization of wounds not closed," she continues. Example: The ED physician examines a 22-year-old patient's scalp wound. Utilizing prolene sutures the physician closes a 2.3 cm single-layer wound. On the claim, you'd report 12001 (Simple repair [...]