Question: The dermatologist treated an established patient with a cut on her lip and used Dermabond to close the 1.8-cm laceration. Should I use a laceration repair code when the only adhesive he used was Dermabond?
Answer: Your code choice will depend on the patient’s insurance. Check out these two coding options:
Patient has Medicare: If the physician uses Dermabond as the only closure material for a simple repair on a Medicare patient, report G0168 (Wound closure utilizing tissue adhesive[s] only) for the service.
Patient has commercial insurance: If the commercial carrier follows Medicare rules, use G0168. However, if the payer does not observe Medicare guidelines, you’ll most likely choose a laceration repair code, even when Dermabond is the only adhesive the physician uses. On the claim, report 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).
Either way: Append 873.43 (Other open wound of head; face, without mention of complication; lip) to the procedure code to represent the patient’s injury.
AUDIO TRAINING EVENT TOMORROW: Lesion excision coding made easy. With Betty Johnson.
Related articles:
- Does Dermabond Warrant Special Code? Question: A pediatrician uses Dermabond to close a patient’s…
- Simple Laceration Repair Code or E/M Code? Answer Could Cost Hundreds Not recognizing a laceration repair that’s included in an…
- Multi-Laceration Repair Coding Case StudiesDo you know when to code repairs that occur in…