1. A

    punch/incisional biopsy with closure

    My provider has documented that she did a punch biopsy with a layered (intermediate) closure. The CPT book states that simple closures are included in a punch biopsy but I have not been able to find any information on if intermediate or complex closures are separately billable with a punch or...
  2. C

    Novitas Solutions JL bundling of benign lesion of .5cm or less with closure

    Medicare is bundling excision of benign lesion .5cm or less with intermediate closure. Based on the CPT manual instructions that intermediate and complex closures should be reported separately, my physician wants to add a 59 modifier to the closure. It is my understanding that Medicare...
  3. H

    Is it ever okay to bill for closure with an Open Fracture?

    There has been debate on whether or not to bill for closure with an open fracture code. Is there ever a situation where we could bill for closure (simple, intermediate or complex) with an ORIF code? We handle trauma orthopedic coding, so sometimes the open fractures are traumatic in nature. Many...
  4. C

    Complex Closure Vs Simple Closure

    Hello, a provider is billing complex closure for this Dog Bite indicated below. CPT 13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm . I feel this does not meet a complex closure, any help on what closure code to bill for this procedure? the guidelines state ligation of...
  5. D

    Excision of mass with closure/ complex repair

    The billing comes over marked 21933, 13101/59, 13102/59. A mass was removed the patient's flank, fine, but the surgeon has underlined this in the chart: A direct approximation of closure was not possible without creating significant additional deformity. Extensive undermining of skin and...
  6. S

    Resuturing Surgical Wound

    Hello! I have a question about post-op periods and resuturing a wound. A patient in my office had an excision on Wednesday. She had post-op bleeding and ended up the ER all night. The ER sent her back to the office in the morning after they were unable to control the bleeding. The doctor...
  7. C

    CPT for Nasolabial Cyst Excision via lateral rhinotomy with complex closure

    Hi, any advise on how to code this ENT case - Left Nasolabial mass/cyst Operation: Excision of left nasolabila mass via lateral rhinotomy approach. pt w/history of cll recurrently identified left nasolabial mass for surgical excision, after fna suggestive of manifestations of cll...
  8. L

    ABThera closure of abdomen

    Please help! The physician placed an ABThera vac after a small bowel resection on a patient with an ischemic bowel. As per the physician the ABThera closure is not a normal vac it goes inside the entire abdominal cavity and states it is similar to a "bogota bag" and is disposable. I have...
  9. hcg

    Need help for Repair of Colovaginal and Colovesical Fistula

    I'm trying to find a code for repair of colovaginal and colovesical fistula. But the codes would lead me to closure of rectovaginal fistula (57300 - 57308) and closure of rectovesical fistula (45800, 45805). Any suggestions? Every help is greatly appreciated. Thank you.
  10. J

    cpt code 31825

    Hi, Does anyone know if cpt code 31825-tracheocutaneous fistula w/ plastic repair include using a muscle flap(15732) for closure of the fistula? Your assistance will be greatly appreciated.
  11. L

    Ear Canal closure

    Is there a specific code for closure of the ear canal, or is that included in the skin graft?
  12. T

    partial closure?

    I was wondering how would you code a partial complex closure. Doc excised an infected cyst from right side of face, deep dissection done, approximately 3 cm area was debrided with help of scissors and metallic curette all around the cavity. the cavity was irrigated with diluted hydrogen...
  13. Skinne

    Integumentary Coding Question

    I am not sure if I have interpreted this correctly. In the Integumentary section of the CPT book under excision of benign or malignant lesions (page 53 or 54 of the 2007 book), it says that if a closure requires an intermediate or complex closure, you need to report the excision in addition to...