karenoliver
Contributor
My office is having trouble appealing our billings of wound closure codes. According to our "Complete Global Service Data for Orthopedic Surgery" published by the American Academy of Orthopedic Surgeons we can bill for wound closures as long as it is NOT for initial surgical exposure (like and I&D of an abscess) and our "deniers" are still refusing to pay. They are stating that once we touch the wound it automatically becomes a "surgical site" and therefore the traumatic wound becomes our site of exposure. We are only billing for these closures when the patient presents on the first treatment day and we are the only surgeons to touch the wound. If another physician has sutured or performed debridement, or packed the wound we do not bill because now it is a surgical site. If the wound is extended for tendon repairs we do not bill for what we incised but rather they only bill the traumatic portion. Are we in the wrong or do we have a valid point? Please comment, if you can include your credentials and any resources you are aware of to support this in either direction it would be appreciated. We just want to do the right thing and if that means not billing for the closures then that's ok. Thanks!
Karen Hayen, CPC
Karen Hayen, CPC