ED Coding and Reimbursement Alert
Reader Question:
Location And Extent Of Closure Are Key When Coding Oral Laceration Repairs
Published on Mon Feb 22, 2016
Question: Should I be coding an intermediate repair (12011) for a laceration in a patient’s mouth since it involves the face and mucous membranes or should I use code 40830 based on the location?
Oklahoma Subscriber
Answer: 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), does appear to describe the simple layered closure of this anatomic area, but the mouth code is more accurately descriptive of the service.
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