You Be the Coder:
Tissue Adhesive Code Depends on Insurer
Published on Tue Jul 01, 2003
Question: My pediatrician used Dermabond to close a superficial 2.0-cm laceration on a childs arm. Which CPT/HCPCS Codes should I report for the procedure?
Nevada Subscriber
Answer: Depending on the payer, you have two code choices: 12001* (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less) or G0168 (Wound closure utilizing tissue adhesive[s] only).
Because Dermabond is a skin adhesive, the closure qualifies for a repair code (12001). CPT specifies that you should use repair codes (12001-13160) to designate wound closure utilizing sutures, staples, or tissue adhesives.
Most insurers pay for repair codes, which also reimburse (1.70 relative value units) more than G0168 (0.45 work RVUs). Therefore, unless the carrier requires a HCPCS code, you should report 12001.
