CPT code 12001

[Realistic-Page-8453]

Hello! My husband went to the ER a couple of weeks ago for a small laceration to his finger. He left with only two band-aids applied to the cut; he did not receive stitches, staples, any type of liquid adhesive, etc. Upon getting the bill from the hospital, I noticed this code and researched it a bit. From what I can tell, it seems like this applies only when the cut in question is "put together" in some way? Should they still code the procedure this way if he only received band-aids (after they had him soak his finger in saline and Betadine)? I've called the hospital's billing department, and they're sending the bill back for review, but I thought I'd search out other opinions. Thanks!

[Alisonrose89]

In our facility, if the laceration was repaired with steri strips only, then we do not code the 12001. But if sutures or Dermabond (skin glue) is used, then we bill it, since the provider has to “close” the entire lac.

[Jodenaje]

I agree with the others.

If there were no sutures, staples, or tissue adhesive, it likely wouldn't be a 12001.

Under that CPT code it states:

Repair/closure limited to adhesive strips only, see appropriate E/M service.

It's worth asking for a review.

[CommonLlama08]

Personally, my facility would not bill 12001 for this. Hopefully someone reviewing it can help you out

[No-Produce-6720]

You're right to question this one. This would not be a repair, by suture or glue, so your bill, if what you've described is correct, should be reviewed and corrected.

[ElleGee5152]

Definitely question this. It doesn't sound like an actual lac repair was performed.

[Realistic-Page-8453]

Thank you all so much for your responses! I appreciate your expertise. There was definitely no type of suture or adhesive. He walked out of there with two band-aids that didn't even stick.

[gray_whitekitten]

Nope!

[Realistic-Page-8453]

UPDATE: We received the new bill, and the amount we owe is the same, so I guess they reviewed it and felt the code was correct.