tci ED Coding & Reimbursement Alert - 2003 Issue 8

Reader Question: Assign E/M for Non-Starred Suture Repair

Question: Our ED physician saw a patient for a suture repair and told her to come back in two days for recheck. She came back in two days and saw a different ED physician. Would there be a charge for that second visit? California Subscriber Answer: CPT language supports using an E/M for a wound check following a starred procedure. For non-starred procedures, look to the introduction to the surgery section, which lists bundled services with the surgical package to include typical follow-up care. Determine whether the wound check represents typical follow-up care on a case-by-case basis. Medicare will...

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