# Multiple Lacs



## LTibbetts (Jan 21, 2010)

I have an ER patient that got bit by a dog and had three different wounds sutured. There was a layered repair on the leg wound and two minor lacs sutured on the arm in two different areas. I know to add the two lac lengths on the arm together, etc, that is not my question. I am wondering in you can also code an E&M for this patient since there was more than one lac treated in different areas on the body. In the exam it states that the general appearance and the psych. were noted with symptoms as well as the wounds. I would also like to know what the case would be if those 2 areas of the body were not noted on the exam and it was just the multiple wounds. It seems to be at the root of a discussion in our office and I need input, please. We do pro fees for ER's.


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## Cyndi113 (Jan 21, 2010)

IMO, if only the lacs treated = charge only for the lacs. Did your MD read x-rays or treat any other injury?


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## LTibbetts (Jan 21, 2010)

No, there were no xrays done and the only injuries were all from the dog bites. They did give him pain meds and antibiotics, though, if that matters.


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## FTessaBartels (Jan 21, 2010)

*Coding for an ER physician*

Leslie,
I think you are coding for an ER physician.  

I believe the rules are somewhat different for ER coding.  You might be wise to post your questions on the ER forum only. 

I do not do ER coding, so I'm *not* certain if this applies to your situation.

In an office setting, an established patient who came in for laceration repair would get just the repair codes and no E/M service, unless there was some significant, separately identifiable E/M over an above that required for treating the laceration(s). 

However, I believe this may be different for Emergency Rooms ... both pro fee and facility. 

Hope that helps. 

F Tessa Bartels, CPC, CEMC


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## LTibbetts (Jan 21, 2010)

Ok, sorry about that. Thanks anyway.


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## Cyndi113 (Jan 21, 2010)

Tessa, that's really interesting. I sent the question to an ER coder. I didn't know the rules were different there.


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