97602 is there another code like this that is not an e&m

darmandahl

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I am trying to answer a question on a test and can't use E&M, only CPT, ICD10CM and Modifiers. 97602 is the best match I can find but it's not scrubbing. All that was done was a dressing change in the ER. Can anyone point me on the right path, I'm at a loss.
 

Chelle-Lynn

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Was anesthesia used? If so, possibly 15852. Or if it was to treat a burn there are a few other specifics under 16020, etc.
 

darmandahl

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97602 or something like it?

Hi, thank you for answering me. No, no anesthesia was used and it wasn't a burn. See it's just two questions:

The patient is coming back to ED per. MD instruction to f/u to check the status of a 3cm laceration to lower leg that he stitched four days ago, no infection, cleansed and dressed then discharged.

The other is a non-venomous snake bite, same thing, inspection, clean and dressing, discharge.

If I was at work i would bill that to E&M but I'm not to use E&M here and all the others had CPT, so I feel like I'm missing something very obvious that I just can't remember or something

Any point in the right direction would be so thankful for.
 

Chelle-Lynn

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On the suture issue, I would check to make that the code does not have a global day criteria. Often time the removal of stitches is included in the application. Check your original code billed for the placement.

On the snake bite, it would appear since it was just an evaluation and dressing, that the original service was billed as an E&M? If so, then you would code as appropriate based on the service rendered on the follow up day.
 
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When choosing the correct code for a debridement procedure on the skin, such as those that an emergency department provider may perform, study the codes from 11000 to 11047, Debridement procedures on the skin.

**excerpt was taken from www.supercoder.com for CPT 97597 under the Lay Terms section subcategory Tips**

Since you say that 97602 is not going through as the acceptable CPT and the use of E&M is prohibited. You mentioned the patient needed to go back to the ED per physician and he cleansed the wound look at 11042. I'm not really familiar with the -A1 (dressing, one wound) modifier and if it can even be used.

The snake bite you really didn't give much information. Were sutures mentioned, depth of puncture, Length sutured? Did that particular patient have both the laceration and the snake bite? If so, than the patient went back to the ED and 11042 would apply because the area of the bite wound was cleansed.

hope this helps
 
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