Part B Insider (Multispecialty) Coding Alert
Payer May Have Opinion on Laceration Repair Method
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Question: If our provider used a tissue adhesive instead of placing a suture, can this procedure be reported using laceration repair codes (such as 12001), or should I report HCPCS code, G0168?
Answer: Depending on the payer, you have two code choices: 12001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less) or G0168 (Wound closure utilizing tissue adhesive[s] only).
You can typically use repair codes from the CPT® range, 12001-13160 when your physician performs wound closure using sutures, staples, or tissue adhesives. So, it is not necessary that you will have to restrict usage of repair codes only when your clinician used a suture for laceration repair. Unless a payer, such as Medicare, is specific about using the HCPCS code, most payers will look for the CPT® repair codes when your clinician performs laceration repair.
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