# Through and through lip laceration



## calicoder10 (Oct 19, 2015)

I am having difficulty coding this lip repair.  Can I get some help with the following :

There are through and through upper (1cm x2) and lower lip (3cm) lacerations crossing the vermilion border.

Repair of the multiple lip lacerations, including 3 cm total length laceration through left lower lip involving the mucosa and vermilion border. And 2 1 cm laceration to upper lip, both including the vermilion border.  Upper lip was anesthetized with bilateral infraorbital blocks using standard technique with 2 total ml of o.5% bupivacaine w/ epinephrine.  Wound irrigated.  Upper lacerations closed with a total of 3 5-0 nylon sutures, vermilion border was approximated first in both cases.  Lower lip laceration was closed with 7 simple sutures of 5-0 chromic gut as majority of the sutures involved the mucosa

upper lip lacerations - 40650

Lower lip laceration - 40652

Thanks,
carmenb


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## kak6 (Oct 23, 2015)

This is what I get: it does not state more than one layer of sutures were used so that takes you to simple repair, 12011 thru 12018. Total length is 5cm for all lacerations, which is 12013. 
 Repairs involving vermilion borders are much more involved that just "vermilion border was approximated first".


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## sswisher (Oct 25, 2015)

The repair does not automatically default to simple closure. The full thickness lip laceration codes do not specifically require layered sutures.  Often two layers are done (particularly if you count skin and mucosa as separate layers).  Sometimes 3 layers (skin, mucosa and deep).  But the number of layers is not a part of the descriptor. In this case, the injury is what determines the code.

https://www.supercoder.com/my-ask-a...ough-laceration-repair-lip-mucosal-vermillion


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