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Pediatric Coding Alert

You Be the Coder:
Do Butterfly Bandages = Repair Code?

Question: A mother brings her 10-year-old daughter to our office because the child fell from her bike and had a laceration on her left knee. A pediatrician examines the patient, cleans the wound and closes it using butterfly bandages. Should I report a laceration repair code for this encounter?Montana SubscriberAnswer: If the wound does not require stitches, staples or tissue adhesive (such as Dermabond), you should not report a laceration repair code. CPT requires you to use one of these closure methods to report 12001-12007 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet] ...).Solution: Roll the work the pediatrician performs closing the laceration into the overall E/M level for the visit. So if notes indicate a level-three established patient office visit, report the following:• 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem-focused history; an expanded problem-focused examination; medical decision-making of low complexity) for the E/M• 891.0 (Open wound of knee, leg [except thigh], and ankle]; without mention of complication) linked to 99213 to represent the laceration• E826.1 (Pedal cycle accident; pedal cyclist) linked to the E/M code to indicate the laceration's cause.