Wiki Nexplanon removal and suture code

[Ocean1529]

We have a provider that is asking to add the CPT code 12001 (simple repair of superficial wounds) when she removes a Nexplanon. (11976) I think suturing the skin is part of the removal code- but I just would like an opinion on what others think? (We have never done it before when removing Nexplanons)

Thank you,
Tracey

 

[CodingKing]

There is an NCCI edit on the repair codes with this code. According to the plain english code medical coding guide I have says incision and closure is part of the primary procedure. most surgical procedures include simple closure unless otherwise specified that it doesn't.

Pere NCCI Manual

Closure/repair of a surgical incision is included in the global surgical package except as noted below. Wound repair CPT codes 12001-13153 should not be reported separately to describe closure of surgical incisions for procedures with global surgery indicators of 000, 010, 090, or MMM. Simple, intermediate, and complex wound repair codes may be reported with Mohs surgery (CPT codes 17311-17315). Intermediate and complex repair codes may be reported with excision of benign lesions (CPT codes 11401-11406, 11421-11426, 11441-11471) and excision of malignant lesions (CPT codes 11600-11646). Wound repair codes (CPT codes 12001-13153) should not be reported with excisions of benign lesions with an excised diameter of 0.5 cm or less (CPT codes 11400, 11420, 11440).

 

[Ocean1529]

Thank you for the information... I agree

 

[Chelle-Lynn]

This is the clinical procedure definition and suture is included:

The physician removes implantable contraceptive capsules. The physician palpates the implantation site and locates all the capsules. If they cannot be located by palpation, a separately reportable radiograph may be obtained to identify the capsules. A local anesthetic is injected. A small incision is made over the capsules. The capsules are dissected from surrounding tissue and removed. The incision is closed.