tci E/M Coding Alert - 2023 Issue Q4

You Be the Coder: Use the Right Modifier in a Laceration Situation

Question: A patient reports to the emergency department (ED) with three lacerations on their right arm. Two of the lacerations required simple repair: one measured 3.3 cm, the other was 1.9 cm. One of the lacerations required intermediate repair, and measured 2.7 cm. The ED physician decided to perform the laceration repairs after an ED evaluation and management (E/M) service that involved moderate-complexity medical decision making (MDM). What CPT® codes should I report for this encounter? Illinois Subscriber Answer: For this claim, report: 12031 (Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and...

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