Wiki Wound Care vs. E/M visit

[AKAJBART]

My Doctor will sometimes put a dressing on an open wound, and by dressing I mean...... Band-Aid and antibiotic ointment. The Office Manager always puts a note on the charge for me to bill the Wound Care.

With that said, I've always been told that unless it requires a Procedure (ie; debridement, sutures, skin removal, etc.) that the Band-Aid and ointment are considered inclusive with the E/M visit code.

Does anyone have any info to help me support this? Or if I'm incorrect, please let me know.

I appreciate your help!

Thanks

 

[Pam Warren]

You're correct. That's not wound care in the sense of debridement or suturing, it's part of the E&M.

Surgical and code guidelines regarding wound care are in both CPT and documented in the CCI edits.

 

[AKAJBART]

Thanks Pam!! Do you, or anyone else, have any documentation to support this?

Also, an E/M would be billed for "Burn Care" when all that was done was: "Applied Silvadene cream and wrapped pinky finger, right hand, 3rd degree burn that happened 7 days ago" - Correct??

 

[Pam Warren]

The guidelines and CCI edits will clarify what constitutes wound care. Anything else does not.