Podiatry Coding & Billing Alert

Question: If the podiatrist uses adhesive strips as the sole repair material for a patient’s wound, should we report a simple repair CPT® code?

Nebraska Subscriber

Answer: No. If the podiatrist uses adhesive strips as the sole repair material for a wound closure, you should report the appropriate evaluation and management (E/M) code, according to the CPT^® guidelines.

For example, the podiatrist uses adhesive strips to close an established patient’s 2.1 cm superficial foot wound. The podiatrist performs an expanded problem focused history, an expanded problem focused examination, and he uses medical decision making of low complexity. In this case, you would report 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity …).

On the other hand, if the podiatrist had instead used staples and suture to close the same patient’s 2.1 cm superficial foot wound, then you’d report 12001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less) for the repair.