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The skin(ny) on G0168: How to code Dermabond

HCPro Coder Connection, December 29, 2004

The skin(ny) on G0168: How to code Dermabond

Coding for the application of the wound adhesive Dermabond (G0168) is enough to raise the hackles of providers everywhere because the same question always arises: Is G0168 separately payable or not?

Thanks to new guidance issued in the 2005 OPPS final rule, the answer is clear: Beginning January 1, 2005, G0168 is considered a supply code, assigned status indicator N, and thus is not separately payable.

"It's really not new guidance. In my opinion, CMS had always considered Dermabond to be a supply," says Valerie Rinkle, MPA, revenue cycle director for Asante Health System in Medford, OR. "But the nice thing about the 2005 OPPS rule is that they actually refer to G0168 as a supply."

G0168 is now a packaged supply with the proper CPT laceration repair code. Do not report it by itself, independently of the repair code series (12001-13160).

Note that you should still include G0168 on your claims with a repair code. "[Dermabond and other tissue adhesives] are N status codes. You still report G0168 so CMS knows to package it with the laceration code," Rinkle says.

Coders unsure of the length and depth of the wound in question should always query the physician, as characteristics of the wound determine the repair code used.

Dermabond coding scenarios
The following scenarios provide examples for coding Dermabond.

Hospital scenario 1: Patient is admitted to the ED with a superficial laceration on his leg less than 2.5 cm in length. Dictation states that the laceration was cleansed and closed with tissue adhesive. Code 12001 (simple repair of superficial wounds; 2.5 cm or less) and G0168.

Hospital scenario 2: Patient is admitted to the ED with a 5.0 cm laceration on her leg requiring layered closure with tissue adhesive and sutures. Code 12032 (layer closure of wounds, 2.6 cm to 7.5 cm) and G0168.

(The above story was adapted from the January 2005 Briefings on APCs.)