The Inside Scoop on Medical Billing for Tissue Adhesives
The Inside Scoop on Medical Billing for Tissue Adhesives
Coding for tissue adhesives can be confusing because there isn’t one set procedure for this. The coding that is used is determined by the type of wound and the severity of the repair when tissue adhesives are used for wound closures.
The answer to this question will be different depending on which entity is paying the medical billing claim. When you code for the use of tissue adhesives, including Dermabond; Medicare has its own guidelines for reporting this procedure that you need to follow to be reimbursed. You should report G0168 for Medicare patients only. If you are reporting the procedure for a non-Medicare patient, you should use the CPT code that is the equivalent and that is 12001-12018 series (Simple repair of superficial wounds …).
Another tip for reporting this claim to Medicare is you may only use G0168 for Dermabond-only laceration repairs in both the inpatient and outpatient settings. If sutures or staples were also used you will have to report this as a layered laceration code on your medical billing form.
Something you may not be aware of is that 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.
Private payers will have different guidelines, a quick check with the payers to see if they follow Medicare guidelines for this type of procedure will let you know whether or not to expect a reimbursement for the service.
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