Wiki lacerations

[lindafay1123]

A ten year old boy fell while riding his bike in his backyard. He had numerous cuts and was brought to the ER by his mother. The ER physician obtained a brief HPI, pertinent ROS and pertinent past medical, social & family histoy. He performed an expanded problem focused examination. Medical decision makin gwas a low complexity. Physician performed a layered closure of a 4 cm laceration of the forehead , a 1.5 cm layered closure of the left external ear and a simple repair of a 2.5 cm laceration of the lip. the icd9 and cpt codes i used was
icp9 : 873.42 cpt: 12053 and 12011 and 99282
872.00 do i need a modifier and do I also need to use
873.43 86.59 18.4 27.51
E826.1
E849.0

please help!

 

[mitchellde]

the 86.59, 18.4, 27.51 are vol 3 ICD-9 codes and are not to be use for Er or physician claims, these are for inpatient facility use only. the only procedure codes you need are the 12053 and the 12011 and I would use a 59 modifer on the 12011 as the payer will bundle your simple into the complex since they are of the same body area. you need a 25 modifier on the 99282, link your dx codes all 5 to the E&M and then forehead and ear to the 12053 and the lip to the 12011