Internal Medicine Coding Alert
Pay Heed to Complex Repair 'Anatomic Groups'
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Question: We had a case with multiple lacerations requiring complex repair to the following sites: scalp — 1.1 cm wound, left arm — 2.1 cm wound, right arm - 6.3 cm wound. Should I report each laceration repair separately and code the case as 13120x2 for the scalp and left arm, and 13121 for the right arm?
Answer: No, you should not report two units of 13120 (Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm) plus one unit of 13121 (… 2.6 to 7.5 cm).
Here’s why: Unlike many codes that you report separately for distinct anatomic sites, the complex repair codes work differently. According to CPT® instruction, the length of the repair is the “sum of lengths of repairs for each group of anatomic sites.” Because 13120 and 13121 include anatomic sites scalp, arms and legs, you should add up the lengths of all complex repairs from all of those sites.
In your example, that means you should add 1.1 cm, 2.1 cm, and 6.3 cm for a total of 9.5 cm.
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Internal Medicine Coding Alert
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