Orthopedic Coding Alert

Reader Question:

Complex Wound Closure

Question: I have a patient who had multiple lacerations on his right and left fingers. Should I separate each digit and each hand by coding all the wounds on the fingers separately, or should I add them up? The physician coded the injuries all together as 13132.

North Dakota Subscriber  
Answer: According to the notes in the repair (closure) section of CPT 2001 (beginning on page 49 of the professional edition), when multiple wounds are repaired, one should add together the lengths of those in the same classification  
 
If all the wounds are of the finger (or extremities as worded in CPT) and require simple closures, you should add them all together and charge one code. You would not add together lengths of repairs from different groupings of anatomic sites, e.g., hand and feet, nor would you combine lengths of different classifications, e.g., simple and complex repairs. If your physician repaired a complex wound closure of the hands and fingers measuring a total of 3.5 cm, code 13132.There should be documentation to support more than a layered closure to include debridement and/or scar revision.
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