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ED Coding and Reimbursement Alert

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To Combine, or Not to Combine: Laceration Repair Lengths

Published on Wed Sep 15, 2010

Question: A patient reports to the ED with a pair of lacerations; notes indicate that after a level-two E/M service, the nonphysician practitioner (NPP) performed a simple 3.5cm laceration repair on the patient's right foot and a simple 4.3cm laceration on the patient's right thigh. How should I report the encounter?Illinois SubscriberAnswer: On the claim, report the following: 12004 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 7.6 cm to 12.5 cm) for the laceration repair99282 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: an expanded problem focused history;an expanded problem focused examination; and low complexity medical decision making ...) for the E/M serviceModifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to 99282 to show [...]
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