Three significant changes that will affect reimbursement rates go into effect January 1, 2026:
Conversion factor changes
Relative Value Unit (RVU) efficiency adjustment
Practice Expense changes
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tci ED Coding & Reimbursement Alert - 2006 Issue 8
Add Laceration Repair Lengths That Have Common Attributes
Get up to speed on laceration coding, because most EDs perform many repairs
When a patient reports to the ED for laceration repair, filing the proper claim depends on wound length, complexity and whether or not the physician performed a separate evaluation and management service during the encounter.Consequences: Laceration coding is not something you want to take lightly in the ED, says Jim Blakeman, senior vice president at Emergency Groups Office in Arcadia, Calif. If you overcode on a laceration claim, denials and suspicious payers are sure to follow. Conversely, undercoding a laceration repair claim will cut...
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