Wiki Does Intermediate Repair Require Superficial Fascia?

[gena379]

We all know the CPT definition ". . . require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin . . .'

Does this mean:
1) One or more of the deeper layers of subq. Period. AND ALSO closure of the superficial fascia. i.e. requires superficial fascia to be closed.
2) "Deeper layers" = includes subq and superficial fascia and you only have to close a minimum of one of those deeper layers. i.e. does not require superficial fascia.

I have read so many differing interpretations on this. The AAD sides with #2 (I directly emailed their coding@aad.org email). I know there is a CPT Assist November 2019 that also says " . . . requires layered closure of one or more of the deeper layers of subcutaneous tissue and in which superficial (non-muscle) fascia is required in addition to the skin . . . "

 

[apoland]

Hello,
I'm late to the party, but I had the very same question myself. I reached out to AAPC earlier this year for input and was given the following response "The AMA guidelines for intermediate repairs don't require the first layer repaired be muscle. The intermediate layer must be subcutaneous tissue and there must be one more layer repaired on top of that (total of two layers)." I code for plastics and the ASPS coding workshop also confirmed the deeper layer repaired must capture part of the subq tissue OR fascia.

I hope this helps.

-Autumn