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ED Coding and Reimbursement Alert

Reader Question:

Don't Talk Out Of Both Sides Of Your Mouth For Oral Laceration Repairs

Published on Tue Feb 21, 2012

Question: When a patient's mouth laceration is repaired, should I be coding intermediate repair (12011) since it involves the face and mucous membranes or the 40830 based on the location? Oklahoma SubscriberAnswer: CPT® instructs to report the code that accurately describes the service provided, in this case 40830 (Closure of laceration, vestibule of mouth; 2.5 cm or less). Your other code suggestion 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less), dose appear to describe the layered closure of this anatomic area, but the mouth code is more accurately descriptive of the service.
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