Primary Care Coding Alert

Question: The FP treats an established 18-year-old patient who has a long,but superficial, cut on his forehead just above the brow. Using Dermabond, the FP closes the 10.2 cm cut. How should I code wound closures with Dermabond? Is this an E/M, or a laceration repair?

Michigan Subscriber

Answer: For this patient, and most patients your FP will treat, a laceration the FP closes with Dermabond is a procedure. On the claim, report the following:

" 12015 (Simple repair of superficial wounds of face, ears, eyelids, nose,lips and/or mucous membranes; 7.6 cm to 12.5 cm) for the repair

" 873.42 (Other open wound of head; face, without mention of complication; forehead) appended to 12015 to represent the patients cut.

The only time a laceration repair is considered an E/M is when the FP uses adhesive strips to close the injury. When the FP performs the repair using Dermabond, sutures, or staples, it is a procedure.

Medicare exception: When your FP performs single-layer laceration repair on a Medicare patient, coding will change; report G0168 (Wound closure utilizing tissue adhesive[s] only) for these patients.

-- Information for and answers to You Be the Coder and Reader Questions reviewed by Kent Moore, manager of health care financing and delivery systems for the American Academy of Family Physicians in Leawood, Kan.