Medicare Compliance & Reimbursement

Tip: Your E/M usually requires 2 components -- which means more than problem-focused. If you pigeonhole encounters involving suture removal as 99212s, you could be cutting yourself short -- or overcharging your service. To tell whether you need to code more or less for laceration follow-up care, answer these five questions. 1: Did You or a Co-Physician Do the Repair? Yes: If your physician or a doctor within your group places the sutures, you cannot bill for their removal,confirms Tracy Russell, CBCS at Carroll Children's Center 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 doctor removes them, you can bill for the wound check and removal. 2: Are You Providing a 2-Day Post-ER Check? "For lacerations done in the ER, we are often called upon to 'evaluate' the wound in two days," explains Charles [...]