Whenever an excision is performed, i.e. a lesion, a simple closure is always included. A simple closure can also be called a nonlayered closure. In this instance, only the excision code would be coded.
An immediate repair involves:
Closure of contaminated single layer wound
Layer closure (subcutaneous tissue, superficial fascia)
Removal foreign material (gravel, glass)
Routine debridement and decontamination
A complex repair is more complicated than the immediate repair, the complexity is defined by the provider, and as such, must be documented to support the complex repair. I always say, document repair was complex and why. A simple notation of "repair complex" is not going to cut it.
1) If documentation doesn't support immediate or complex repair, you are coding the excision only.
2) If there is an indication of immediate or complex repair, (as per descriptions above) you may code BOTH the excision and the repair.
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