Dermabond

Patient was seen the ER, has medicare, wound closed with Dermabond. For the facility charges, we have an ER level, G0168 with 2 units for the dermabond, and also the CPT® code for the facility procedure charge, I have not put on the Doctor's fee, that is the part I do. I don't think the hospital charges are correct, and my supervisor is getting an error that G0138 is not valid. And she has asked me to look for a HCPCS Code for the dermabond, I told her it is included in the procedure, but she thinks we need to charge for it as well as the procedure code. Any Advice? As I do the Professional coding and don't have much experience with the facility side.

re: Dermabond

I would say that the reason that you are getting the error is because of the G0138 I found the code description for it and it states " wound closure utilizing tissue adhesive only" that would contradict the charge for the procedure. If we have a pt that has dermabond applied we use the simple repair based on the length and anatomic site. I too upon putting the G0138 into the encoder said that it was in valid, we do not apply G codes so I wan unfamiliar with the verbage of it but once I looked it up it made sense. Also ou may want to point out to her what it states in the CPT® book what is defined as a closure, and the definition of the simple repair. I also found as far as that G code is concerned under medicare coverage status it states "carrier judgement". I am including a really helpful link to a site I use daily check it out. Hope this helps!
http://www.icd9data.com/HCPCS/2013/G/G0168.htm

re: Dermabond

I agree.

But there is also a reference from AHA Coding Clinic that states:

According to the instructions publised by CMS in the 2005 OPPS final rule HCPCS code G0168 has been moved from status indicator "X" which was separately payable to status indicator "N" of which there is no separate APC payment. Effective January 1, 2005 payment for HCPCS code G0168 will now be packaged into whichever procedure(s) are billed on the same date of service and will not be separately payable. Therefore, effective January 1, 2005, HCPCS code G0168 should be reported in addition to the CPT® codes for simple repair.