Wiki Laceration Repar?

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calicoder10

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Would this be reported as a simple repair?

"Laceration Repair of of hand:I anesthetized the area with a local block. Excellent anesthesia was obtained. The wound was then cleansed and irrigated. I re-explored the wound and found no foreign body. I then ligated bleeding artery using 1 cutaneous suture of 3-0 vicryl in a figure 8 with excellent hemostasis. The wound was dressed with surgicel, xeroform and ace wrap. Total length 7.5 cm"
 
Not 12001 because there's no documentation of a laceration repair. This was a ligation of a blood vessel. The last portion of the CPT instructions for lacerations (just prior to the actual codes) directs you to 20100-20103.
 
sswisher said:
Not 12001 because there's no documentation of a laceration repair. This was a ligation of a blood vessel. The last portion of the CPT instructions for lacerations (just prior to the actual codes) directs you to 20100-20103.
Click to expand...

Yes it does, however those CPT codes are used for surgery and this is a simple laceration repair so 12001 is a better code to use.
 
I'm torn between both answers but i'm leaning towards 20103. It does say laceration repair. But ligation of artery sounds more complex than simple ligation of a vessel which is included in the repair codes.


carmenb said:
Would this be reported as a simple repair?

"Laceration Repair of of hand:I anesthetized the area with a local block. Excellent anesthesia was obtained. The wound was then cleansed and irrigated. I re-explored the wound and found no foreign body. I then ligated bleeding artery using 1 cutaneous suture of 3-0 vicryl in a figure 8 with excellent hemostasis. The wound was dressed with surgicel, xeroform and ace wrap. Total length 7.5 cm"
Click to expand...
 
Agree with CodingKing re cpt based upon provided documentation.

Regarding 12001 and why it doesn't apply:

Although the provider wrote "laceration repair" and the wound was 7.5 cm long, the actual laceration closure seems to be surgicel and dressings. These don't qualify for a laceration code. CPT has very clear minimum requirements for a separately billable laceration repair: "Use the codes in this section to designate wound closure using sutures, staples, or tissue adhesives..either singly or in combination with each other, or in combination with adhesive strips."

Perhaps there is missing documentation regarding the method of wound closure? However according to the provided documentation, the single suture was a figure 8 for ligation of an artery. The provider does not state the figure 8 was for skin or fascial closure. Figure 8 sutures for vessel ligation may extend to the skin surface, but that doesn't make it a wound closure. A different kind of figure 8 could be used for wound closure, but that isn't documented in this case.

More on figure 8 ligations here: http://lacerationrepair.com/special-situations/vascular-injuries-part-ii-ligation-techniques/
 
Agree with 20103, although lac repair done, you bill for the more complex px with the higher RVU in this case not the lac repair and instead ligation. If it were only a simple repair of the skin and not the artery code 12002 due to measurement lac.
 
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