New Codes Expand Billing for Laceration Repair
Published on Sat Apr 01, 2000
Until Jan. 1, 2000, otolaryngologists and other surgeons had to use one code (11330, now deleted) to describe any complex repair of lacerations of more than 7.5 cm. Consequently, whether the surgeon repaired eight or 18 centimeters, he or she was paid the same amount. CPT 2000, however, has included four new add-on codes that should be used in such situations.
Repair, or closure, of wounds or lacerations is performed using sutures, staples or tissue adhesives. Coding for such repairs can be confusing because these procedures are categorized in three different ways: by anatomic site, the depth of the wound and the size of the repair.
Correctly Code Simple Repairs
When a wound is superficialwhich CPT defines as involving primary epidermis, dermis or subcutaneous skin tissues without significant involvement of deeper structuresits repair is considered simple. According to CPT, such repairs require one single-layer closure and include local anesthesia and electrocauterization of wounds not closed.
For simple repairs, the CPT codes differentiate between the face and the rest of the body. They also are broken down by the size of the wound or laceration being repaired:
12001simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less
120022.6 cm to 7.5 cm
120047.6 cm to 12.5 cm
1200512.6 cm to 20.0 cm
1200620.1 cm to 30.0 cm
12007over 30.0 cm
12011simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
120132.6 cm to 5.0 cm
120145.1 cm to 7.5 cm
120157.6 cm to 12.5 cm
1201612.6 cm to 20.0 cm
1201720.1 cm to 30.0 cm
12018over 30.0 cm
Note: CPT 2000 now differentiates between wounds closed with adhesive strips and those closed by other means. According to CPT, all the codes listed in this article should be used to designate wound closure utilizing sutures, staples, or tissue adhesives, either singly or in combination with each other, or in combination with adhesive strips. Wound closure utilizing adhesive strips as the sole repair material should be coded using the appropriate E/M code. In addition, Medicare says that wounds closed with tissue adhesives only (e.g., Dermabond) should be reported by using a new HCPCS codeG0168, wound closure utilizing tissue adhesive(s) onlyno other code should be used when billing Medicare.
Get the Right Code for Intermediate Repair
Intermediate repairs are more complicated. They require layered closure of one or more of the deeper layers of subcutaneous tissue and non-muscle fascia in addition to the skin closure, CPT says. Also included in this category are heavily contaminated wounds that, even though they are single-layer closures, require [...]
