Wiki Reopening of Wound/Seb Cyst Removal - layered closure

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ahonkomp

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A patient came in and had a sebaceous cyst removed from their back and sutures were placed. We charged 11402. 9 days after this the patient presented and the wound had reopened. (she had had the sutures removed the day prior) The physician re-sutured the 5cm wound and did a layered closure. How should this be coded? Its still in the global period for the 11402. I looked at 12020 but that is for simple closure. 13160 doesn't seem quite right either but maybe it is? Also considered just using the regular repair code(12032) with a modifier. Any help is greatly appreciated
 
If you use a repair code or 12020, you won't need any modifier, as these don't bundle with excisions. (If you use 13160 you would need one, but I don't think there is one that applies.)

Modifier 78 is not used in dermatology because it requires a return to the OR or procedure room, which CMS defines as a "place of service specifically equipped and staffed for the sole purpose of performing procedures. [This] does not include... a minor treatment room."

However, I'm not really sure if you can bill for these anyway, since CMS prohibits billing for "all additional medical or surgical services required
of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room."

posed a question the other day about billing for 12020 (or 13160) during the post op period. See thread "repair of wound dehiscence."
 
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