Wound Length & Medical Billing Laceration Claims

Wound Length & Medical Billing Laceration Claims

When processing medical billing claims for multiple laceration repairs – which is common when processing paperwork on an auto accident and many emergency room claims; normally you won’t add the repair lengths unless you have wounds that require exactly the same type and amount of care and are at roughly the same anatomic location as defined by CPT coding.

The medical billing is easy enough to figure out on most multiple laceration claims. If there are different types of repairs you will use separate CPT codes on your medical billing.

If you have multiple lacerations in the same area, CPT explains this by specifying, “When multiple wounds are repaired, add together the lengths of those in the same classification and from all anatomic sites that are grouped together into the same code descriptor.” There are only three classifications for use with the medical billing and those are “simple”,”intermediate” and “complex” repairs.

A good example of when to separate the medical billing claims with be if a patient had a 1.5-cm laceration of the eyebrow, and the surgeon performs an intermediate level repair. This same patient also has a 3.6-cm forehead laceration that requires a simple repair. Since these were two different levels of repair in the same area, your medical billing claim would be filed as separate procedures performed by the physician on the medical billing claim form.

If these lacerations had been the same level of repair, then you would have added the length of the wound as one and only filed one claim since the lacerations were in the same anatomical area.

If you remember this simple tip, you will find that filing multiple laceration claims for you medical billing reimbursements will go much smoother for your practice.

View all Articles by: Melissa Clark, CCS-P