New Codes Expand Billing for Laceration Repairs
Published on Sat Jan 01, 2000
" CPT 2000 introduced several add-on codes for the repair of lacerations. These codes may be confusing at first, but by using them properly surgeons can legally maximize their reimbursement for wound repairs.
Until Jan. 1, 2000, general surgeons had to use one code (11330, now deleted) to describe any complex repair of lacerations of more than 7.5 cm. Consequently, whether the surgeon repaired a wound of eight or 18 centimeters, he or she was paid the same amount. Now, however, CPT 2000 has included four new add-on codes for such situations, says Kathleen Mueller, RN, CPC, CCS-P, a coding and reimbursement specialist in the office of Allan K. Lieffer, MD, a general surgeon in Lenzburg, Ill.
Repair, or closure, of wounds or lacerations is performed using sutures, staples or tissue adhesives. Coding for such repairs can be confusing, because these procedures are categorized in three different ways: anatomic site, the depth of the wound, and the size of the repair.
CPT 2000 provides codes for three types of laceration repairs: simple, intermediate and complex (for a more complete discussion of these repairs, see side bar on page 4). Within each of these categories, there also are separate codes depending on the anatomic site of the wound that is being repaired.
Correctly Code Simple Repairs
When a wound is superficialwhich CPT defines as involving primary epidermis, dermis or subcutaneous skin tissues without significant involvement of deeper structuresits repair is considered simple. Such repairs require one single layer closure and include local anesthesia and electrocauterization of wounds not closed.
For simple repairs, the CPT codes differentiate between the face and the rest of the body and are further broken down by the size of the wound or laceration being repaired:
12001simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less
120022.6 cm to 7.5 cm
120047.6 cm to 12.5 cm
1200512.6 cm to 20.0 cm
1200620.1 cm to 30.0 cm
12007over 30.0 cm
12011simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
120132.6 to 5.0 cm
120145.1 cm to 7.5 cm
120157.6 cm to 12.5 cm
1201612.6 cm to 20.0 cm
1201720.1 cm to 30.0 cm
12018over 30.0 cm
Note: CPT 2000 now differentiates between wounds closed with adhesive strips and those closed by other means. All the listed codes should be used to designate wound closure using sutures, staples, or tissue adhesives (e.g., 2-cyanoacrylate), either singly or in combination with each other, or in combination with adhesive strips. Wound closure using adhesive strips (such as Dermabond) as the sole repair material should be coded using the appropriate evaluation [...]
