1) Laceration: Deep cut in skin. 3 types of lacerations are there.

233243

Simple Laceration: (12001-12007) Single layer closure with local anesthesia.

Intermediate Laceration: (12031) Layered closure and it is used for heavily contaminated
wounds or extensive cleaning.FOREIGN BODY REMOVAL

Complex Repair: (13100) Multiple layered closures used more complicating techniques like
debridement, scar revision, stenting.tendon involvement

2) I&D: Incision and drainage to release puss or pressure built under skin. Such as cellulitis and
abscess. 10060

Simple I&D: (10060) This situation only drained the puss from cyst or abscess.no packing material
used.after drainage wound will opened.

Complex I&D: (10061) Pack with sterile gauge such conditions cellulitis and abscess.

Drain placement,Subsequent packing,breackup loculations

3) FRACTURE CARE: These are two types of fractures, 90 days global period 57modifier and 54
used.

Definitive Care: It is minimally displaced or non displaced fractures.with out broken skin but
broken bone. another name is closed fracture.(noes,clavicle,finger toe), without performing
manipulation, administering pain medication, applying a splint or medical tape to stabilize the
injury, and explaining the plan of care. A common example of this code is 28510 (Closed
treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each).

Restorative Care: Displaced fractures are treated with manipulation to bone realignment of
anatomical site. long bone fractures. like(femur,tibia fibula). restorative care, and it refers to the
provider actually manipulating the damaged bone in order to realign it for proper healing. This
type of care works best for several kinds of common fractures, including those of the fingers,
toes, metacarpals, fibulae, and radii, as well as both bimalleolar and trimalleolar ankle fractures.
For example, if a patient presents with a distal radial fracture and the provider uses manual
manipulation to set the injury, then it should be coded with CPT code 25605 (Closed treatment of
distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed
treatment of fracture of ulnar styloid, when performed; with manipulation).
4) SPLINTS: It is using to stabilize the fracture or damaged bones.

Two types of Splints

Custom Splints: Custom splints are constructed by hand therapists (Need to be coded splints)

✓ Thumb Spica Splint (short arm splint)

✓ Sugar Tong

✓ Double Sugar Tong Splint

✓ Long Double Sugar Tong Splint

✓ Posterior Ankle Splint

✓ Posterior Elbow Splint

✓ Posterior Short Leg Splint

✓ Posterior Long Leg Splint

✓ Stirrup Splint

✓ Boxer Splint

✓ Ankle Stirrup Splint

✓ Ankle Sugar Tong Splint

✓ Long Arm Splint

✓ Radial & Ulnar Splint

✓ Long Leg Splint

✓ Short Arm Volar Splint

✓ Ortho ( Fiber Glass) Glass Splint

✓ Ulna Gutter Splint

✓ Plaster Splint

✓ OCL (Plaster) Splint

✓ Medial Lateral Splint

✓ Dorsal Volar Splint

✓ Coaptation Splint
Prefabricated Splints: Readily available in the market. (Need not to be coded Splints)

➢ Ace Wrap

➢ Gel Splint

➢ Cock-up Splint

➢ Knee Immobilizer

➢ Hard Shoe

➢ Equalizer Boot

➢ Aircast/Airsplint

➢ Air cell, Foam, Gel Components

➢ Bledsoe Brace

➢ Colle’s Splint

➢ Bulky Jones

➢ Jone Dressing

5) Critical Care Management: Life threatening conditions like respiratory failure, CPR, acute
MI, brain injury.

99291: 30 to 74 minutes

99292: More than 74 minutes

Bundled Procedures:

Pulse Oximetry

Gastric Intubation

Ventilator management

Chest x ray

Blood gasses
Unbundled Procedures:

Chest tubes

CPR 92950

Wound repair

ECG interpretation 93010

Electrical Cardioversion 92960

Endotracheal Intubation 31500

6) CPR: (92950)

7) Lumbar Puncture: (62270) A needle is inserted between two lumbar bones L3-L4
(vertebrae) to remove a sample of cerebro spinal fluid.

Performed diagnosis was migraine,meningitis,multiple sclerosis.

8) Central Line Placement: (36555) Central venous catheter that is placed in large veins like
subclavian vein,jugular veins.it is used in two types.

Diagnostic type:

Is repeat blood collection,

Therapeutic type:

Is used give fluids,and medications.

9) Epistaxis: Acute hemorrhage from the nostril,or Control of nose bleeding.it is two types
1)Anterior 2)Posterior.

Anterior Epistaxis: Most common

Simple: (30901)
Limited packing -cotton boll or gauze

Silver nitrate cautery for 10 sec

Complex: (30903)

Rhino rocket

Merocel Gauze

Vaseline Gauze

Multiple attempts limited packing

Multiple attempts cautery

Extensive packing (complete occlusion of nasal cavity)

Nasal ballons

Posterior Epistaxis: (30905)

Passing a catheter through one nostril or both nostrils through the nasopharynx and out the mouth.
To control bleeding that is coming from the posterior (back) of the nose.

10) Foley Catheter: (51702)

A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine. Left 2-12 weeks

Straight Catheter: (51701)

The straight catheter, also called an intermittent catheter, is a soft, thin tube used to pass urine from
the body. Straight catheters are usually made of plastic (PVC) and are only used one time and then
thrown away.

11) Moderate Sedation:

 Moderate Sedation is a drug induced depression of consciousness.

 The patient maintains the ability to respond purposely to verbal direction or verbal
direction either alone or accompanied by light tactile stimulation.

 Interventions are not required to maintain the patient’s airway

Same physician performing Different physician performing

15 mins < 5 years 99151 99155

15 mins > 5 years 99152 99156

Additional 15 mins 99153 99157

12) Arthrocentesis: (20600)

Arthrocentesis (synovial fluid/joint aspiration) is used to drain synovial fluid from the joint capsule to
relieve pain, pressure, or to perform laboratory testing if an infection is suspected.

13) Digital Nerve Block: (64450)

Digital nerve block is utilized when there is trauma or infection of a digit. While there are a few
variations in which this procedure can be performed, these are again, provider specific. Digital nerve
blocks consist of injecting an anesthetic into the general area surrounding the digit in order to
provide anesthesia to the area being examined/repaired.

14) Foreign Body Removal:

Most ear and nose foreign bodies can be removed by a skilled physician in the office with minimal
risk of complications.

Common removal methods include use of forceps, water irrigation and suction catheter.

15) Debridement: (11042-11047)

The removal of damaged tissue or foreign objects from a wound.

16) Excision: (11400-11646)

The removal of tissue using a sharp knife (scalpel) or other cutting instrument