Primary Care Coding Alert

Question: Our FP recently performed simple repair of a laceration of the scalp for a Medicare patient. The length of the laceration was 2 cm. Instead of using sutures to close the wound, he used Dermabond. Can I report the laceration code 12001 for the repair even though no sutures were placed during the procedure?

Michigan Subscriber

Answer: According to CPT^® rules, you can report laceration repair codes such as 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) when your clinician performs laceration repair and uses sutures, staples or tissue adhesives either alone or in combination. Going by these rules, it might be ideal to report 12001 for the repair your clinician performed as ‘Dermabond’ is a tissue adhesive.

However, Medicare requires use of a different code when your clinician uses only tissue adhesives to repair a wound. This code is the HCPCS code, G0168 (Wound closure utilizing tissue adhesive[s] only). However, you should reserve the use of this code for Medicare patients only and not for other payers. Since the patient is a Medicare patient in your case, you can report G0168 for this simple repair that your clinician performed.