Did you ever get a reply, I am I am wondering the same thing. Does intermediate closure include suturing and application of steri-strips? I know steri-strips alone would be an E/M service, but do steri-stips count for layer closure?
closure codes
does layered closure include the subq sutures applied and exterior wound closure with steristrips would this constitute a layered closure?
I found the CPT guidelines state, "Use the codes in this section to designate wound closure utilizing sutures, staples, or tissue adhesives (eg, 2-cyanoacrylate), either singly or in combination with each other,
or in combination with adhesive strips. Chemical cauterization, electrocauterization, or wound closure utilizing adhesive strips as the sole repair material are included in the appropriate E/M code.
The repair of wounds may be classified as Simple, Intermediate, or Complex. "
"
Simple repair is used when the wound is superficial (eg, involving primarily epidermis or dermis, or subcutaneous tissues without significant involvement of deeper structures) and requires simple one-layer closure. Hemostasis and local or topical anesthesia, when performed, are not reported separately."
"
Intermediate repair includes the repair of wounds that, in addition to the above, require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin (epidermal and dermal) closure. It includes limited undermining (defined as a distance less than the maximum width of the defect, measured perpendicular to the closure line, along at least one entire edge of the defect). Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair."
So, the provider excises a 4 cm mass and "was closed with 5 0 nylon in interrupted fashion..." "...areas were washed Steri-Strips applied dry dressing placed". For this example, there were a total of four masses excised, I only provided one as an examples as they were documented all the same. Would this qualify for the intermediate layer closure?
I am thinking that it would be applicable as an intermediate closure since there are steri-strips used in combination with the suture closure. Does anyone else agree?