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Lisa m Posted Tue 17th of April, 2012 21:13:33 PM

Can 12020 be billed in a post op period? Scenario.....15823 and 67900 billed in surgical center, patient comes in office a month later and 12020 is performed. Is this billable?

SuperCoder Answered Tue 17th of April, 2012 21:28:28 PM

Wound dehiscence code 12020 (Treatment of superficial wound dehiscence; simple closure) describes repair when there is no sign of infection. In this case, the surgeon simply debrides and irrigates the wound and closes it in a single layer. If infection is evident, the surgeon may prefer to clean the wound and pack it with gauze strips, leaving the wound open to allow infection to drain. In this case, 12021 (… with packing) is the better choice. If the dehiscence has opened and requires closure in multiple layers, report 13160 (Secondary closure of surgical wound or dehiscence, extensive or complicated).

If repair of wound dehiscence occurs during the postoperative (or global surgical) period of a previous procedure, be sure to append modifier -78 (Return to the operating room for a related procedure during the postoperative period) to the appropriate repair code. This tells the insurer that the procedure is the result of a complication arising from an earlier procedure

Lisa m Posted Thu 19th of April, 2012 15:43:49 PM

But, if the patient does not "return to the operating room" as the dehiscence is done in the office and the sx was done an ASC, it is not billable correct?

SuperCoder Answered Thu 19th of April, 2012 21:04:03 PM

Yes if the patient does not return to the OR, 12020-78 cannot be reported.

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