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Otolaryngology Coding Alert

READER QUESTIONS:

Extra Cleaning Earns Intermediate Repair

Published on Fri Feb 24, 2006

Question: Our ENT removed extensive debris from a wound that then required a single-layer closure. Should I report this service with a code for wound repair or a code for foreign-body removal?


Ohio Subscriber
Answer: Because the doctor performs extensive removal of particulate debris, you should report an intermediate code for the repair, such as 12051 (Layer closure of wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less).

Tip: CPT states that -single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.- Payers following CPT rules recognize the extra work of the extensive cleaning and removal through more intensive and higher-valued intermediate repair codes.
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