Wound Closure Medical Billing -Dermabond or Stitches?

When a wound needs closing and a tissue adhesive is used the medical billing coding can be different than when sutures or stitches are used.

There are specific guidelines for medical billing when tissue adhesives are used. All adhesives including Dermabond have their own unique way of being reported on medical billing. Consult with Medicare or the carrier to ensure that you are meeting those guidelines prior to submitting your medical billing.

There are five basic guidelines that Medicare requires in order to reimburse for this service and many carriers follow the same criteria for laceration closures utilizing Dermabond. You should report G0168 for Medicare patients only; the CPT code equivalent to G0168 is the 12001-12018 series (Simple repair of superficial wounds …)is the equivalent to the G series used in Medicare billing. You can report G0168 for Dermabond-only laceration repairs in both the inpatient and outpatient settings

If the physician uses sutures or staples with Dermabond to perform a laceration repair, you can report only the layered laceration repair code based on the length and site of the wound, and you should not use G0168. Additionally, you should not report G0168 when the provider uses tissue adhesive strips for simple laceration repairs.

Here is a tip regarding reimbursements, Medicare assigns a payment status indicator of “N” to G0168, meaning it represents an incidental service. You can report the code, but you won’t receive any reimbursement for it from Medicare payers.

View all Articles by: Melissa C. - OMG, LLC. CEO