Primary Care Coding Alert

Question: A new patient came into the office with a laceration of her forearm. The doctor repaired and evaluated the arm on an emergency basis. All appointments were held up for over half an hour due to the emergency. Can we code 99058 in addition to 99025 to account for the emergency? Maryland Subscriber Answer: You can bill 99058 (Office services provided on an emergency basis) and 99025 (Initial [new patient] visit when starred [*] surgical procedure constitutes major service at that visit) together, but be aware that most carriers do not reimburse 99058.

You should also use the appropriate code for the laceration repair, such as 12002* (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet); 2.6 cm to 7.5 cm). Use 881.00 (Open wound of forearm; without mention of complication) for the diagnosis code.

Both 99025 and 99058 are adjunct codes, which means that they need to be used in addition to another CPT code (in this case, 12002). Answers to You Be the Coder and Reader Questions provided by Kent Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians.