ED Coding and Reimbursement Alert

Question: How should we code and get reimbursed for use of Dermabond? Our cost for this is $20.

Jerry Ward, MD
Gifford Medical Center, Randolph, VT

Answer: Dermabond poses significant coding and reimbursement challenges because there is no CPT code for a Dermabond repair, and there is no HCPCS code for the supply. Cole points out that her company has made several attempts to obtain more guidance from carriers on how to code and bill for Dermabond, and their experience has been that each interpretation varies. Our advice from CPT was to use an appropriate evaluation and management (E/M) code since there was not an accurate code in CPT to describe the use of Dermabond, Cole says. Meanwhile, she notes, a Pennsylvania carrier, Xact Medicare, has published in its coverage manual that Dermabond is considered an integral part of the surgical repair codes (12001-12021). That particular carrier also has stated that Dermabond has been approved for use on simple, superficial wounds that are easily closed. The bottom line is find out what your specific carrier believes is the appropriate use of Dermabond, Cole recommends. But, in general, with an appropriate procedural note, you should feel comfortable using the simple laceration codes when Dermabond is used to repair superficial wounds, she says.