tci ED Coding & Reimbursement Alert - 2005 Issue 6

READER QUESTIONS: Nix -54 With Laceration Repair

Question: We performed a laceration repair, but because our physician may not end up doing the suture removal, should we append modifier -54 to the laceration repair code?Iowa Subscriber Answer: According to the Medicare Carriers Manual, Medicare considers laceration repairs to be minor procedures, and you don't need to append modifier -54 (Surgical care only) to minor procedure codes, regardless of whether your physician will perform the follow-up care.With payers that follow CPT guidelines, however, the answer is less clear. CPT has not officially commented on whether you should report modifier -54 in scenarios involving minor procedures...

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