tci ED Coding & Reimbursement Alert - 2007 Issue 12

Reader Question: Adverse-Reaction Pay Depends on Insurer

Question: The ED physician performs simple repair on a 4.6-cm laceration on a patient's right shoulder. Two days later, the patient returns complaining that his wound is inflamed and painful. The physician finds an infection in the patient's shoulder, and treats the wound with antibiotics. Can we charge a patient visit in this scenario? Kentucky SubscriberAnswer: Because the second visit happened during the global period of the laceration repair (12002, Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.6 cm to 7.5 cm), the answer will depend on the patient's...

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