If the patient had multiple lacerations of the same repair complexity on the same body part, the lengths of each wound should be added together to determine the code. The goal of laceration treatment is to repair a wound safely without increasing risk of infection and with optimal cosmetic results. Within the field of dermatology, procedures are assigned global periods based on their level of complexity. The 11101 code requires a number modifier to indicate how many additional biopsies were performed. A future article in this series will be devoted to modifiers, but it is important to note some of the most important modifiers related to performing procedures with global periods.
Simple surgical repairs are repairs that do not include dermal sutures. When two or more surgical codes are billed together, a modifier code s must be appended to one or more of the surgical codes. Oxford reserves the right, in its sole discretion, to modify policies as necessary without prior written notice unless otherwise required by Oxford's administrative procedures or applicable state law. Simple wound repair procedures, 12001 through 12021,. By using our Services, you agree that www. Dermatologists perform many different procedures on a daily basis, so understanding the guidelines for proper billing and documentation of procedures is vitally important. Mutually exclusive procedures are two or more procedures that are usually not performed during the same patient encounter on the same date of service.
Local anesthetic and chemical or electrocauterization are used of wounds not closed. Also referred to as a ragged wound, it may be caused by a blunt object or machinery accidents. We provide information to help copyright holders manage their intellectual property online. Simple repair can be billed for chemical and electrocauterization of wounds not closed and include local anesthesia. . If the code in the left column is billed with any of the codes in the right column, one of the codes will deny. If the code in the left column is billed with any of the codes in the right column, one of the codes will deny.
This code is used for the simplest type of superficial repair of wound that does not exceed 2. The next article in this series will discuss in detail the dermatologic procedures associated with both 10-day and 90-day global periods. The single-layer closure of a heavily contaminated wound that requires extensive cleaning or removal of particulate matter also may also be considered an intermediate repair. These are 5 position alpha- numeric codes representing primarily items and nonphysician services that are not represented in the level I codes. Providers should refer to www.
For example, a patient who underwent Mohs with graft repair develops a rash 2 weeks later. Whether curved, angular or stellate the repaired wound should be measured in centimeters and must not exceed 2. Note: the payment amount for anesthesia services is based on a calculation using base unit, time units, and the conversion factor. The American Academy of Dermatology has taken a stance against eliminating global surgical periods, and thus far no legislation has been passed to effectively eliminate the global period but providers should be aware the concept of global surgical periods may change in the future. Debridement of a laceration is included in a simple repair codes. If multiple biopsies are performed of the same thing ie, a rash , the specimen should go in 1 container and the provider should only code for 1 biopsy. Only repair lengths within a web site can be added up.
These are 5 position numeric codes representing physician and nonphysician services. It applies to all medical, surgical and hospital services, nursing, medicines, and mechanical, surgical aids provided for treatment of a claimed work-related injury. Therefore upper or lower eyelid skin that does not involve the lid margin, would be coded using the normal skin biopsy codes Table 1. The provider should be aware that certain anatomic sites are considered special and therefore have different skin biopsy codes than the normal 11100 and 11101 series. Effective Date for recently added codes. The codes are mutually exclusive. About 6 million patients seek laceration treatment in emergency departments every year, according to a 2017 American Family Physician report.
Surprisingly, Mohs surgery is considered a zero-day global procedure. All registered trademarks, used in the content, are the property of their owners. The codes are mutually exclusive. If you think somebody is violating your copyrights and want to notify us, you can find information about submitting notices and www. A laceration refers to an injury that causes a skin tear.
However, unless otherwise indicated, a modifier may be used to request separate payment if the criteria for web site the use of the modifier are met. Physician Documentation is Critical for Accurate Coding Medical coding outsourcing is practical option to negotiate the maze of laceration repair codes and guidelines. Many Mohs procedures end up being associated with a 90-day global period due to the type of repair performed, but if a Mohs defect is repaired with second intention or simple repair, it will not have any postoperative global days. Items that are not included in the global surgical package: the initial evaluation for surgery major surgeries only and unrelated procedures or office visits with appropriate modifiers. A global period is defined as a length of time associated with a procedure, and its part of the global surgical package. Jan 1, 2015 … 2015. Comprehensive physician documentation is vital to determine the complexity and size of the repair s.
0 
Star