MAWK
Networker
Patient came into the clinic with a laceration the provider sutures the laceration would I bill just the laceration repair or would I bill the laceration with an e/m visit with a modifier and the repair
I differ.
If the patient presents with a laceration, and a significant amount of work goes into evaluating the laceration, then an E/M may be warranted as well as this is a new problem and an evaluation must be made by the provider.
For example, what if the provider made a judgment that the wound did not need to be closed? Is the visit free? No. We would charge an E/M. So it would stand that just because the wound requires closure does not mean we can't get paid for the work that went into making that decision. It's not bundled.
Things that would mark the significance of a separately billable E/M are: determining depth, presence of foreign bodies, exploration of the wound, and judgment on how best to close the wound (sutures, staples, dermabond, etc).
The above are payable criteria under the E/M guidelines. I'd look close at the documentation.
The only time I will not bill an E/M separately is if the visit is a return to clinic for a previously evaluated condition that warrants a procedure at a future visit. The evaluation has already been made and paid. But at some point, the evaluation happens.