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ED Coding and Reimbursement Alert

How do you decide which category describes the repair in question?

Published on Wed Jul 24, 2013

  • A simple repair is usually single layer, with no particulates, no contamination. You’ll report simple repairs with codes from the 12001-12021 CPT® family, depending on the length and location of the repair.
  • An intermediate repair usually involves layered closure of one or more of the deeper layers in addition to the skin, or a single layer repair that requires extensive cleaning and removal of particulate debris. Check the 12031-12057 code set for when filing claims for intermediate repairs, depending on the length and location of the repair.
  • A complex repair usually includes the repair of wounds requiring more than layered closure employing wound techniques such as extensive undermining, stents, or retention sutures. Management of the wound usually includes creation of a defect for repairs or the “debridement of complicated lacerations or avulsions.” Complex repairs are reported using CPT® codes 13100-13160.

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