ED Coding and Reimbursement Alert

Question: We saw a patient with an eyelid laceration and the ED physician repaired it. We weren’t sure which of the integumentary system codes applied to the situation. Can you advise?

Pennsylvania Subscriber

Answer: Look to the integumentary section of your CPT^® code book to find the correct code for an eyelid laceration repair.

Codes from the repair (closure) section of CPT^® include codes for eyelid repairs such as 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose lips…; 2.5 cm or less).

Select the most accurate code depending on the thickness of the repair. You can also consider codes from the ophthalmology section if they accurately describe the service provided, such as  67930 (Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness) if the ED provider performs a partial thickness repair, or 67935 (... full thickness) for full thickness lid laceration repair.