kimb, (in my opinion) If the sole purpose of the visit was for laceration repair - then that's all I would code. If the provider had to do a "more than usual" to assess the laceration (often they do more with head lacerations - more of a neuro/extremity type of exam depending on the situation), then coding the procedure and E/M with a .25 modifier on it is fine. However, keep in mind they always have to assess the laceration, check it out - decide what/how to close it IF they're closing it, etc. that's expected and that's all included in the laceration repair code. It's only when it goes above and beyond what's normally required that you can code and E/M with that. It doesn't have a to be a different dx code, it can be the same. Let me add, usually - with "simple" repair of anything, an E/M level isn't justified. Again, I say "usually", (sometimes it is, like with head injuries/lacerations).