# delayed primary closure-I am uncertain



## sfinnegan

I am uncertain as to what CPT code to use when coding a delayed primary wound closure. For example, if a patient has a simple amputation (toe) and returns 1 week later for closure, there are no complications, the wound might be irrigated and then is  sutured. Would this be CPT 13160/12020 or some other repair code? There is no dehiscence.

Thanks,

Susan


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## preserene

13160 is for secondary closure (it does not mean 'delayed closure'). For secondary closure there should had been a surgical procedure(wound) before which went for wound gaping( dehiscence) of its own accord. So it is not correct code for our purpose.
12020 is also for wound dehiscence but superficial which goes for simple closure or just packing.
 This delayed suturing/ or repair was intentional  and it was like a staging procedure the surgeon opted for. Is in it? It could go with Modifier- 58.
I hope I am at the right path.
let us see another experts opinion to come through, (if you are not convinced!) and for the benefit of accuracy.
Thank you


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## sfinnegan

sometimes when the physicians amputate the toe, for example, they plan on closing the wound later so yes, it's staged and modifier 58 would be great but I am unsure what CPT code to use for a delayed primary closure. 

thanks


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## preserene

I opt for  the Primary procedural code you used for the  Primary procedure  with modifer 58 appended to it
 The patient is still in the global right?


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## sfinnegan

Yes, still in global. Thanks for all your help/suggestions.


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## schofielda

*delayed primary closure*

I'm drawing a blank. If the surgeon performs the procedure, packed the surgical wound and wrapped, with the intent to do additional debridement and closure 2-3 days later, would the original procedure require a modifier 52 for reduced services?  Thanks.


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