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ED Coding and Reimbursement Alert

READER QUESTIONS :

Check Materials on Closure Encounters

Published on Wed Jul 08, 2009

Question: A patient reports to the ED after stepping on a rusty nail at a picnic. After examining the patient and making sure the wound was free of debris, the ED physician performs a tetanus injection and repairs the 0.8 cm hole in his right foot with sutures. Can I report a laceration repair code in this scenario? Indiana Subscriber Answer: Since the ED physician used sutures, you can submit a laceration repair code. However, tetanus shots are not reportable in the ED, so roll the injection work into the overall E/M level. On the claim, report the following: " 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) for the repair " the appropriate-level E/M code, such as 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key [...]
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