Pediatric Coding Alert

Question: I found a HCPCS code for Dermabond. Can I use G0168 instead of a CPT wound repair code?

Ohio Subscriber Answer: No. The HCPCS G code (G0168, Wound closure utilizing tissue adhesive[s] only) is for Medicare use only. For private payers, stick with the CPT simple repair code (12001-12018).

Although commercial carriers still recognize the existing CPT codes for simple laceration repair using Dermabond, Medicare restricts the CPT laceration repair codes to placement and removal of sutures and staples. Medicare created G0168 because it felt repairing a laceration with Dermabond was not comparable to sutures/staples placement and removal.

Bonus: The repair codes contain a higher value than the G code. The 2007 Medicare Physician Fee Schedule assigns 2.32 transitional nonfacility total relative value units to G0168, which equates to a national rate of $87.92 (2.32 x 2007 conversion factor of 37.8975). By comparison, the simplest laceration repair in CPT --2001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less) -- offers 3.79 RVUs (unadjusted rate of $143.63). The practice expense component of 12001 includes the cost of the Dermabond product.