Reader Question ~ Dermabond Coding Depends on Payer
Published on Thu Oct 05, 2006
Dermabond Coding Depends on Payer
Question: How can we code for using tissue adhesives, such as Dermabond, for wound closure?
Illinois Subscriber Answer: Coding for tissue adhesives, including Dermabond, has its own guidelines for Medicare. Remember these five rules for using G0168 (Wound closure utilizing tissue adhesive[s] only) for laceration closure with Dermabond only:
1. You should report G0168 for Medicare patients only.
2. If you treat non-Medicare patients, the CPT code equivalent to G0168 is the 12001-12018 series (Simple repair of superficial wounds ...).
3. You can report G0168 for Dermabond-only laceration repairs in both the inpatient and outpatient settings
4. If the physician uses sutures or staples with Dermabond to perform a laceration repair, you can report only the layered laceration repair code based on the length and site of the wound, and you should not use G0168.
5. You should not report G0168 when the provider uses tissue adhesive strips for simple laceration repairs. Payment tip: Medicare assigns a payment status indicator of -N- to G0168, meaning it represents an incidental service. You can report the code, but you won't receive any reimbursement for it from Medicare payers.
Private payers may specify different guidelines: For non-Medicare carriers, the CPT code equivalent to G0168 is 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less). Check with your payers to determine if they follow Medicare guidelines or specify 12011 for Dermabond repairs.
