Internal Medicine Coding Alert
Dermabond/Suture Combo Calls for Wound Care Code
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Question: An established Medicare patient reports to the internist after falling from the stairs on his front porch. He has a laceration on his lower right arm and is complaining of a headache. The internist cleans the wound and makes a layered closure of 2.7 cm on the patient's arm, using sutures and Dermabond to close the wound. The internist then performs a problem-focused history and examination on the patient to address his headaches. Can I report the Dermabond repair code in this scenario? Answer: You should not include the Medicare code for Dermabond repair (G0168, Wound closure utilizing tissue adhesive[s] only) in this scenario.
Missouri Subscriber
Why? If your internist uses sutures or staples and Dermabond to close a laceration repair site, you can report only the layered laceration repair code, and you should not report G0168.
On your claim,
• report 12032 (Layer closure of wounds of scalp, axillae, trunk and/or extremities [excluding hands and feet]; 2.6 cm to 7.5 cm]) for the laceration repair.
• attach 913.0 (Superficial injury of elbow, forearm and wrist; abrasion or friction burn without mention of infection) to 12032 to represent the patient's arm injury.
• attach E880.9 (Fall on or from other stairs or steps) to 12032 to represent the cause of the patient's arm injury.
• report 99212 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a problem-focused history; a problem-focused examination; straightforward medical decision-making) for the E/M service.
• append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to 99212 to show that the E/M service and the repair were separate.
• link 784.0 (Headache) to 99212 to represent the patient's headache.
• link E880.9 to 99212 to represent the cause of the patient's headache.
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