Questions for Dr. Stern

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93. An issue came up regarding billing for an avulsion laceration of a finger where the use of gel foam was applied. My biller/coder stated that we don't get reimbursed for the gel foam and can only code an E & M code for this, no laceration CPT code. If you saw this in your urgent care practice, how would you bill and code for this type of injury to maximize your reimbursement?

Thank you for contacting Practice Velocity.

I am not the bearer of good news in this case. There is no specific code for the procedure of applying the Gelfoam, as this physician work is included in the E/M code.
What can you code for?
1. E/M
2. supplies used
3. local anesthesia (90772: subcutaneous or im injection) OR digit/metacarpal block (64450: nerve block. . . other peripheral nerve or branch), if either was performed to allow for cleansing the wound.

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David Stern, MD, CPC CEO, Practice Velocity Partner, Physicians Immediate Care Board Member, Urgent Care      Association of America Dr. Stern helped design the patent-pending Practice Velocity template (PiVoT) that is now used in over 240 urgent care centers. He is board certified in internal medicine and served as Chief Resident in Internal Medicine at Pennsylvania State University. Dr. Stern received his medical degree from Jefferson Medical College of Thomas Jefferson University after completing undergraduate studies at Houghton College in Houghton, NY. Dr. Stern serves on the Board of Directors of the Urgent Care Association of America (UCAOA). A Certified Professional Coder, Dr. Stern writes articles and presents at numerous national and regional conferences on topics, including medical charting, emr, medical coding and medical practice management. With additional partners of John Koehler, MD (CEO) and Terry Buzzard, MD (Regional Medical Director), they operate the urgent care consulting firm of National Med Network and the ten clinics (in Illinois and Oklahoma) of Physicians Immediate Care.

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