Outpatient consultation resulting in laceration repair

CPT® 99223 - 57
CPT® 13152

Would this be correct? Or do I use a different consultation code?

re: Outpatient consultation resulting in laceration repair

Who consulted you? Was this in the office? New patient to you? Insurance type?

re: Outpatient consultation resulting in laceration repair

ER doctor asked our general surgeon for a consultation. Patient was seen in the ER, never seen by our surgeon before. The insurance is Anthem

re: Outpatient consultation resulting in laceration repair

The code is therefore an ED visit code, with the -57. There are 5 levels, don't think a laceration would get you to to a level 5.

re: Outpatient consultation resulting in laceration repair

Thank you. The surgeon was thinking it was 99223 I thought that was for admission.

re: Outpatient consultation resulting in laceration repair

99223 is not a consultation code nor an outpatient code.

re: Outpatient consultation resulting in laceration repair

Code 13152 has a 10 day global. If performed at the same time as an E/M service--add modifier -25 to E/M code.

re: Outpatient consultation resulting in laceration repair

in place of the 57? 57 is for major surgery?

re: Outpatient consultation resulting in laceration repair

In place of. only use modifier 25 on the EM code

re: Outpatient consultation resulting in laceration repair

The place of service doesn't determine whether to use modifier 25 or 57. That is determined by the number of global days. See the articles in Codapedia on the topic.

You mentioned the highest level E/M code for the visit: were a comprehensive history and exam performed? high MDM?

re: Outpatient consultation resulting in laceration repair

thank you for your help.

re: Outpatient consultation resulting in laceration repair

inpatient 99221-99223; Outpatient 99201-99215 (Medicare)