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multiple laceration repairs

  1. #1
    Location
    Lauderdale Lakes, FL
    Posts
    19
    Default multiple laceration repairs
    Medical Coding Books
    Please assist...

    I'm having a rather intense discussion with my ER doc on this one.

    Patient presents with 3 lacerations - chin, lip and vermilion border, each less than 2.5 cm.

    Do we bill 12011, 12011-59 x 2 or do we add up the total length and bill 12014?

    Can you point me to something definitive in writing I can show this "non-believer"?

    P.S. I think its the 3 units, not the combined length.

  2. #2
    Default laceration
    Quote Originally Posted by SherryMoss View Post
    Please assist...

    I'm having a rather intense discussion with my ER doc on this one.

    Patient presents with 3 lacerations - chin, lip and vermilion border, each less than 2.5 cm.

    Do we bill 12011, 12011-59 x 2 or do we add up the total length and bill 12014?

    Can you point me to something definitive in writing I can show this "non-believer"?

    P.S. I think its the 3 units, not the combined length.
    I believe it goes by anatomical site. So, you would combine all those lengths that are inclusive in the descriptor.
    Here's what CPT assistant has to say:
    Complex repair of two/more anatomical sites - vignette
    CPT Assistant, December 1998 Page: 5 Category:
    Related Information
    Note from 3M:
    As of January 1, 2000
    Ÿ 13300 has been deleted. To report, see codes 13102, 13122, 13133, and 13153 for the specific site.


    Reporting a Complex Wound Repair over 7.5 cm

    Clinical Example #2

    The following vignette illustrates when CPT code 13300 currently should be reported for repairs totalling more than 7.5 cm involving two or more anatomic sites:

    A 32-year-old woman was involved in a motor vehicle accident sustaining a 10 cm laceration to her forehead, a 6 cm laceration to her right cheek, a 5 cm laceration to her left cheek, a 4 cm laceration to her chin, and a 9 cm laceration to the dorsum of her right hand. Complex repairs were required for all of these wounds, a sum of 34 cm total length.

    CPT code 13300 should be reported once. Based on the above reporting criteria, the involved anatomy is inclusive of the singular descriptor of CPT code 13131, Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 2.6 to 7.5 cm. In this specific scenario, it was appropriate to total the lengths of the wounds (34 cm) for which code 13300 should be reported.

    In the instance where two complex wounds were repaired (each over 7.5 cm) but in different anatomic sites (not included in the same code descriptor) code 13300 should be reported twice (13300 and 13300-59).

    For example, a 10.0 cm laceration on the trunk and another 12.0 cm laceration on the forehead. Each of those lacerations are greater than 7.5 cm. Again, neither of these anatomic sites are included in a single code descriptor. Therefore, these procedures should be reported as 13300 and 13300-59.

    Editor's Note: For CPT 2000, the CPT Editorial Panel is considering a proposal requesting the deletion of code 13300 and the establishment of four new CPT codes to more accurately quantify the work involved. The Panel has also addressed revision of the instructional notes to the Repair (Closure) heading of the Surgery, Integumentary System section to further clarify multiple wound repair reporting.




    CPT Assistant © Copyright 1990–2009 American Medical Association. All Rights Reserved

  3. #3
    Location
    Johnstown, Pennsylvania Chapter
    Posts
    40
    Default
    if you look in the CPT book under repair simple (pg 58) right above the 12001. This sentence states "Sum of lengths of repairs for each group of anatomic sites."

    For the lip (vermilion border) you might want to look under 40650...not sure what you documentation states but this might be of use.

  4. #4
    Location
    Lauderdale Lakes, FL
    Posts
    19
    Default
    thanks all for the "enlightenment"

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