Wound repair 2012 question about modifier

MATHEODO

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According to the 2012 CPT if wound repair is accomplished using multiple classifications (simple, intermediate, complex) you use modifier 59. This is a pretty big change from previous years.

The question is….what if you are not using different classification, just different anatomic groupings with in the same classification? For example: 12004 for a 7.8 simple repair of the trunk and a 12013 5.2 simple repair of the face...Would we use modifier 59 or continue to use 51 since the classification didn't change, just the anatomical grouping changed?
 

jk2003

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12004 and 12013 are different groups of anatomic sites... use 59. If different anatomic sites within the same group, combine the sum of all repairs. If same anatomic group, but different classifications of repair (simple, intermediate, complex), I would apply 59 to the less complicated ones.
 
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Coding edge feb.2012 tst yourself wound repair

I'M A NEW CODER AND THOUGHT I UNDERSTOOD WOUND REPAIR, YET I HAD DIFFICULTY WITH THIS TEST YOURSELF QUESTION FROM CODING EDGE 2/2012 QUEstion 5A 57-year-old man is involved in an industrial accident and presents for removal of a spiral- shaped shard of steel shrapnel that flew from his lathe and got embedded deep in his right trunk. Extensive undermining and debridement of 9 cm is done to remove the metal and disinfect the wounded area. The undermined flaps, totaling 27.86 sq cm, are bound together to achieve closure. In the heading of the op. report, the dermatologist documents this as an “adjacent tissue rearrangement.” Proper CPT® coding for this scenario would be:

A. 12031
B. 13101
C. 13121, 13122
D. 14021, 13121, 13122

AFTER THREE "WRONG" ANSWERS, THE CORRECT IS "D'"
EVEN AFTER READING THE RATIONAL I STILL DON'T UNDERSTAND WHY AN ATT/R CODE IS APPORPRIATE.
CAN SOMEONE ENLIGHTEN ME?
 

jk2003

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I'm not sure about you or anyone else, but would like to see the closure specifically documented to bill it. We can't just assume it was a complex closure.
 
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Tissue advancement

Wendy ... This is a very abbreviated note ... what I don't understand is how they can code BOTH the tissue rearrangement AND the complex closure for the same wound.

Something is definitely not right here.

F Tessa Bartels, CPC, CEMC
 
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