ED Coding and Reimbursement Alert

Question: Can we bill for wound checks? The physician performed an I&D one day, and the patient returned two days later for repacking.


Idaho Subscriber
Answer: According to CPT, typical postoperative care is included as part of the surgical package. So in this case, whether you should bill the wound check separately depends on what your ED typically does for patients on whom the physicians perform incision and drainage (I&D) procedures, and how complicated the initial service was.
 
If the wound check falls outside of typical care for the initial service, it may represent a separate service, which you could report with a low-level evaluation and management code such as 99281 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: a problem- focused history, a problem-focused examination, and straightforward medical decision-making) or 99282     (... an expanded problem-focused history, an expanded problem-focused examination, and medical decision- making of low complexity).