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Simple Repair Coding?

  1. #1
    Default Simple Repair Coding?
    Medical Coding Books
    I have a question about simple repair....I want to think this one is a simple repair, but the physician questioned if it qualified as "simple repair" or if it would be coded differently..

    Situation: Patient came in for laceration of thumb that occurred 2 days ago. Patient bandages it but today when he tried to remove the dressing it was stuck and he had to pullit off and it started bleeding. He was unable to stop the bleeding. Laceration of the thumb was draped after bein anesthetized with .7 cc Xylocaine and a single 5-0 suture was placed, leaving the rest of the wound open to allow drainage, dressing was placed. Patient to return in 7-10 days to remove suture.

    Is this considered simple repair 12001 since one suture was placed?
    thank you for any advice and input!!

  2. #2
    Duluth, Minnesota
    per the PDR description of procedure 12001, also the current CPT book description, AND the information you provided, it certainaly sounds like a simple wound repair...

    is there something specific that leads you to believe it doesn't qualify as a simple laceration repair? The fact that it was an "old" wound?.... stitches were still placed, anesthesia was used,...

    my vote is - it's a simple repair..
    Donna, CPC, CPC-H

  3. #3
    Fort Smith, AR
    I would code the repair as 12001... However depending on physician documentation it could be more. If he described the layer of skin, debridement, or contamination, it could be considered more.

    Check out page 4 on this for more information... I know it's older but the information seems accurate.

    Darla Sims CPC, CPC-H

  4. #4
    I considered it to be the 12001 simple repair, however the physician questioned since they only did one stitch on the old laceration, and they didn't "stitch" the whole laceration length that maybe it wouldn't qualify.... I told the physician that if it was one stitch or three, it's still considered a "repair" Thank you very much for the replies!

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