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ED Coding and Reimbursement Alert

Coding Strategies:

Make Sure Your Wound Recheck Policy is All Sewn Up for Accurate Coding

Published on Wed Jul 20, 2011

Medicare changes to the simple repair codes will cost you money, unless you know these tips.You've probably noticed lower 2011 payments for simple laceration repairs (CPT® codes 12001-12018) since follow-up care in the ED is no longer included as part of these services. Staying extra vigilant about the assigned Medicare global period can help you recoup full deserved payment for these frequently-performed procedures.Background: Medicare changed the payment policy for simple laceration repairs for 2011 by changing the global surgical package from ten days to zero days. Basically this means that the follow-up visit for a wound check and suture removal is no longer included in the payment for suturing, stapling or using tissue adhesives on superficial wounds primarily involving the epidermis or dermis without deeper damage.Rationale: The change came about in part because Medicare officials did not believe it was typical for emergency department patients to return to the ED [...]
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