# laceration of the lip repair



## KELLI (Nov 30, 2010)

Should I use 40650? or 13150??

INDICATIONS: The patient sustained a through-and-through laceration
to the left side of the lower lip on Monday of this week.  States
that she went to the emergency room, and spent 8 hours, then went
home; went to the emergency room again the next day on Tuesday, at
which point she was told she would need a plastic surgeon to repair
the laceration.  She was seen in the office yesterday with a
diagnosis of through-and-through irregular laceration of the lower
lip.  The patient was brought to the operating room today for
debridement and repair.

DESCRIPTION OF PROCEDURE: After satisfactory IV sedation had been
accomplished, the lower lip was infiltrated with 1% Xylocaine with
epinephrine, prepped externally with Betadine.  All wound edges were
debrided to get sharp margins, and to get rid of old tissue.  Any
bleeders were electrocoagulated.  The orbicularis muscle of the lower
lip was approximated with interrupted 5-0 chromic.  The external
portion of the laceration along the vermillion border white roll and
externally on the mucosa was closed with 5-0 Prolene; the mucosal
portion closed with interrupted sutures of 4-0 chromic.  The patient
tolerated the procedure well, discharged to recovery awake, alert, in
satisfactory condition.


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## capricew (Dec 1, 2010)

There doesnt seem to be enough information to code this properly.
40650 specifies vermillion only and the op note isnt real clear if this is the case.
13150 is the integumentary code for complex repair for 1 cm or less but again the op note does not give sufficient information to choose this code either. 

My recommendation would be to query the doctor on whether or not the repair included more than just the vermillion, how deep did he have to repair the laceration (skin, muscle, fascia etc) and how big of a repair in cm was completed.  

Sorry if this doesnt help


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