ED Coding and Reimbursement Alert

Question: What category of repair would you assign for this patient? I’ve included the note details below:

Wound Repair of 4.2 cm subcutaneous laceration to palmar aspect of middle phalanx of left middle finger and palmar aspect of middle phalanx of left ring finger and palmar aspect of middle phalanx of left index finger. Linear shaped. Minimal bleeding noted. Gross contamination. Distal neuro/vascular/tendon intact. Anesthesia: Digital block administered with 8 mls of 1% lidocaine. Wound prep: wound requires Extensive cleansing with Betadine 500 ml X 2, Wound explored extensively, considerable foreign debris removed, copious irrigation. Skin closed with 16 4-0 Ethilon using Simple sutures. Patient tolerated well.  

New York Subscriber

Answer: Given the documentation of gross contamination of the wound and need for extensive cleaning, with removal of debris, you would report this as an intermediate repair 12042 (Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 to 7.5 cm) for both fingers, because you would add the repair lengths together since they are from the same classification and anatomical site. Remember that a single layer closure where extensive cleaning is required can be coded as an intermediate repair.