ED Coding and Reimbursement Alert

Question: If a physician performs a digital block on a finger and repairs a 2 cm laceration, would the correct codes for these procedures be 64450 (Injection, anesthetic agent; other peripheral nerve or branch) and 12001-51? Thanks so much for any help.

Virginia Subscriber

Answer: CPT® states that the digital block is included in the simple laceration repair code stating, The following services are always included in addition to the operation per se:

• Local infiltration, metacarpal/metatarsal/digital block or topical anesthesia
• Subsequent to the decision for surgery, one related Evaluation and Management (E/M) encounter on the date immediately prior to or on the date of procedure (including history and physical)
• Immediate postoperative care, including dictating operative notes, talking with the family and other physicians
• Writing orders
• Evaluating the patient in the post-anesthesia recovery area
• Typical postoperative follow-up care

So report only the 12001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less without the modifier along with an ED E/M code if documentation supports that it was separately identifiable.