Question: A patient presented to our facility with a long laceration on her leg caused by a broken pane of glass. The physician cleaned and closed the cut with sutures. It was a single-layer closure of a 13.6-cm wound, but the physician spent 42 minutes cleaning glass out of the area before closing it. Is this a simple or intermediate repair?
Louisiana Subscriber
Answer: The extra work involved raises this procedure to intermediate status. Report the repair with 12035 (Layer closure of wounds of scalp, axillae, trunk and/or extremities [excluding hands and feet]; 12.6 cm to 20.0 cm).
CPT 2006 states that a simple repair “requires simple one-layer closure,” which accurately describes the closure in this situation. However, CPT also reports that “single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.”
You can use repair codes when the physician closes the wounds with sutures, staples or tissue adhesives. You can also use the codes if two or more of these closure methods are used in combination on the same injury.
If adhesive strips are used with these closure methods, you should still report repair. When adhesive strips are the only closure method, choose the appropriate E/M code to report the repair.
Keep the following descriptions in mind when coding for wound repair (definitions for each type of closure begin on page 57 of CPT 2006):
Simple repairs (codes 12001-12021) close superficial wounds, usually on the epidermis or dermis, or subcutaneous tissues without significant involvement of deeper structures, with a simple, one-layer closure. You also use simple repair codes to report local anesthesia, chemical cauterization or electrocauterization.
Intermediate repairs (codes 12031-12057) also close superficial wounds but also require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial fascia, in addition to the skin closure. Also use these codes to report single-layer closure of a heavily contaminated wound that requires extensive preclosure cleaning or removal of particulate matter.
Complex repairs (codes 13100-13160) close wounds that need more than layered closure, such as scar revision, debridement, extensive undermining, stents or retention sutures. Before completing a complex repair, the doctor must either create a defect for repairs (e.g., excision of a scar requiring complex repair) or debride complicated lacerations or avulsions. The complex repair definition does not include excision of benign or malignant lesions.
