Part B Insider (Multispecialty) Coding Alert

Published on Thu Aug 16, 2007 PDF

Watch out: CPT codes 12001-12007, for simple repair of superficial wounds, become components of four dozen codes each from the musculoskeletal system section in the latest Correct Coding Initiative update, effective Oct. 1.

In a nutshell: Thanks to CCI, you probably can't bill for one of those superficial wound repair codes at the same session as a deep excision, a tissue graft, a radical tumor resection, a deep incision and drainage (I&D), a radical resection, a spine surgery or a lesion excision.

Layered wound closure codes 12031-12037 and 12041-12047 will also become components of most of the same surgical codes.

Complex wound repair codes 13100-13132 (except for the add-on codes) are also slated to become components of a couple of dozen surgical codes.

Similarly, superficial facial wound repair codes 12011-12018 became components of a number of surgical codes, including several facial fracture care codes. Layered facial wound repair codes 12051-12057 and complex facial wound repair codes 13150-13152 will be components of many of the surgical (and facial fracture care) codes as well.

You can use a modifier to override those edits, but be prepared to justify the need for a separate wound repair.

CPT codes 12020-12021, for treatment of superficial wound dehiscence, also became components of around 58 surgical codes. Again, you can use a modifier to override these edits.