Pediatric Coding Alert

Montana Subscriber

Answer: If the wound does not require stitches, staples or tissue adhesive (such as Dermabond), you should not report a laceration repair code. CPT requires you to use one of these closure methods to report 12001-12007 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet] ...).

Solution: Roll the work the pediatrician performs closing the laceration into the overall E/M level for the visit. So if notes indicate a level-three established patient office visit, report the following:

• 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem-focused history; an expanded problem-focused examination; medical decision-making of low complexity) for the E/M

• 891.0 (Open wound of knee, leg [except thigh], and ankle]; without mention of complication) linked to 99213 to represent the laceration

• E826.1 (Pedal cycle accident; pedal cyclist) linked to the E/M code to indicate the laceration's cause.