ED Coding and Reimbursement Alert

Question: Can we report a subcuticular closure, single layer (referring to closure technique not suture type) forehead laceration repair with a simple-repair code? Here is an excerpt from the physicians dictation: ... using 6-0 nylon in a running subcuticular suture, plastic surgery was obtained. There was good approximation of the wound edges. Benzoin and steri-strips were then applied. Diagnostic Impression: Laceration of the forehead, 1 cm, subcuticular closure.

Barbara Gedwill, RN, CPC
Mequon, Wis.

Answer: The subcuticular closure is very sophisticated and achieves excellent cosmesis (meaning it will heal better cosmetically), but it is still a single-layer, simple facial closure (12011*, simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less). An example of a layered closure would be if the physician documents three 5-0 vicryl sutures were placed subcutaneously and six 5-0 ethilon sutures were placed percutaneously. Typically two different suture materials indicate an intermediate or layered closure (12031*-12057).