General Surgery Coding Alert
Layers Don't Always Determine Repair Code
Question: How should I report repair of an irregular, 3.5-cm laceration of the chin involving subcutaneous tissue and muscle? Answer: The repair meets the requirements for an intermediate closure in several ways and, therefore, you should consider 12052 (Layer closure of wounds of face, ears, eyelids, nose, lips, and/or mucus membranes; 2.6 cm to 5.0 cm).
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An intermediate repair involves layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin closure, according to CPT.
CPT also states that extensive cleaning and removal of debris for even single-layer closures constitutes intermediate repair. Also, the additional non-skin layers the surgeon closed are consistent with an intermediate repair.
In contrast, to consider a closure complex, you need more than just multiple layered closures. To code for a complex repair, look for documentation describing that in addition to layered closure, the surgeon corrected a defect or performed extensive debridement of tissue.
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