jeudi 11 juin 2015

laceration repair needs E/M?

I don't know why I'm having so much trouble deciding whether to code an E/M visit in which a laceration repair (12002) is done. (Yes, newbie here.) I've read posts and articles and guidelines...still uncertain. An experienced co-worker told me since this is a new problem and first time evaluated and decided to do the repair, I would pick up an E/M with modifier -25 as well as the procedure code for the repair.

But, from CMS.gov, Global Surgery Fact Sheet (Medicare): For some minor procedures (as with 0 or 10-day globals), "visit on day of the procedure is generally not payable as a separate service."

The patient fell from a bike. The SOAP note focuses entirely on what happened, exam of injured areas, and then a description of repair of a 6 cm laceration on chin. TDaP given, strict wound precautions given. (end of note)

I will code as: 873.44, 12002

Do I also code E/M visit with modifier -25?

Thanks in advance!



laceration repair needs E/M?

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