ED Coding – 2 Semi Real Life Scenarios

To say that I have had a challenging week would be an understatement. In the past seven days I managed to fall down the stairs of my back deck and out of bed. You heard it I fell out of bed. So in light of these humorouss accidents I decided to do a video and blog about coding lacerations and the like.

I did not do the ICD-10 coding for either of these scenarios but I challenge you guys to do it and put your answers in the comments below or email them to me at angiethecoder@gmail.com.

Also, for the sake of simplicity we will be assuming a level 3 ed visit was appropriately documented for both of these scenarios. In the future I will be happy to do some E/M leveling if you guys are interested.

SCENARIO ONE –  Pt falls down flight of stairs and sustains 2 cm laceration of the scalp and hip contusion. ED doctor injections lidocaine into the scalp for numbing and then does a 2 cm simple laceration repair of the scalp. Assume a  separately identifiable level 3 ED visit was documented.

Coding for SCENARIO ONE –

99283-25 – ED visit

12001 – Simple Laceration Repair of the Scalp

Note you should not bill the 96372 for the injection of the lidocaine because it was used for numbing for the laceration repair and is included in the 12001.

SCENARIO TWO – Pt falls out of bed and hits her chin on her nightstand. She sustains a 2 cm laceration of the chin, a 4 cm laceration of the left arm, an abrasion of the left knee, and a dislocation of left shoulder.  NS infusion was started  to KVO. Then Zofram was given IVPush for nausea and Dilaudid was given IVpush for pain. ED physician treats 2 cm chin laceration with Dermabond and does 4cm simple laceration repair of arm after injecting lidocaine to numb around the wound. NS was infused for 45 mins to KVO.  Versed was given IV push for sedation then physician successfully treated should dislocation with gentle traction . Assume documentation supports  separately identifiable level 3 ED visit.

Coding for SCENARIO TWO –

99283-25

23650 – tx shoulder dislocation

12011-51 – Simple repair of 2cm laceration of chin (Dermabond is considered a simple repair)

12002-51 – Simple repair of 4cm laceration of left arm

For physician coding you would  not report the administration codes for the IV Pushes because physicians are not supposed to report those when in a facility setting according to Chapter 11 page 4 of the 2018 NCCI Manual.  If you want to go out and look at this manual yourself you can get it here

If you want to watch the video I did on this click here.

Thanks!

Angie

 

 

 

 

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