# Laceration repair



## angbart80 (Dec 5, 2017)

I have a disagreement with another coder on the definition of simple vs. intermediate laceration repair.  They will only code intermediate if there's a foreign body noted, however, I feel if they use the term "extensive cleaning" I feel like that would make it an intermediate repair.  The code book says:  

Simple repair is used when the wound is superficial; eg, involving primarily epidermis or dermis, or subcutaneous tissues without significant involvement of deeper structures, and requires simple one layer closure. This includes local anesthesia and chemical or electrocauterization of wounds not closed.

Intermediate repair includes the repair of wounds that, in addition to the above, require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin (epidermal and dermal) closure. Single-layer closure of heavily contaminated wounds that have required *extensive cleaning or removal of particulate matter also constitutes intermediate repair*.

I consider the OR to mean this OR that.  So it can have a foreign body OR need extensive cleaning.  Here's an example: 

Laceration: 
Wound Repair of 1cm ( 0.4in ) subcutaneous laceration to left arm.
Linear shaped.. No foreign body noted. Distal neuro/vascular/tendon  
intact. Anesthesia: Wound infiltrated with 3 mls of 1% lidocaine w/ 
Epi. Wound prep: Extensive cleansing, Copious irrigation. Skin closed 
with 1 4-0 Prolene using Interrupted sutures. Dressed with 
Bacitracin, Kerlix. Patient tolerated well. 

The patient had a dog bite, which I consider to be a dirty wound...  It didn't have a FB, but needed to be cleaned extensively.  The other coder says simple, I say intermediate.  Who's correct?


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## ellzeycoding (Dec 5, 2017)

You are correct.

If it's a contaminated wound that that is a single layer repair *and *it requires extensive cleaning, it is intermediate.

or 

If it's a contaminated wound that that is a single layer repair *and *it requires removal of particulate matter, it is intermediate.


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## angbart80 (Feb 1, 2018)

*contaminated or not?*

So how would you code the laceration example I gave above?  They don't mention "contamination," they only say extensive cleaning.  Gotta love the gray areas of coding!! LOL


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## torresjeffreyp@gmail.com (Dec 8, 2018)

I will code the above example as Intermediate repair. Documentation of "Extensive cleaning" or "Copious Irrigation" warrants Intermediate repair.


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