Basics about Laceration Repair CPT Codes
The CPT codes for wound repair of skin and subcutaneous tissue are classified as simple, intermediate or complex depending on the use of sutures, staples or tissue adhesives. Any one of these repair can be used for wound repair. Cpt Code 12001 is the starting cpt code used for simple repair. This CPT code 12001 is used only for repair of wound used which is superficial. The simple repair is not used for deeper wounds. We have separate CPT codes for intermediate and complex repair for deeper wound repair. Before going ahead we will just learn about the different types of wound repair.
Simple Repair: The superficial wound repair of the epidermis, dermis or subcutaneous tissue is included in simple repair. Only one layer closure or suturing is required in simple repair. Cpt Code 12001 is an example of simple repair. Simple repair is not used for deeper wound. Cpt Codes 12001-12018 are used for simple repair of superficial wounds.
Intermediate Repair: Heavily contaminated wounds which require extensive cleansing or removal or particulate matter and needs one or more deeper layered closure of subcutaneous tissue are included in intermediate repair. The CPT codes 12031-12057 are used for intermediate repair of wounds.
Complex Repair: Complex wound which require more layered closure like debridement, scar revision or complicated lacerations etc. are included under complex repair. It involves layered suturing of torn, crushed or deeply lacerated tissue. Stents or retention sutures are also included in complex repair of wound. Cpt Code 13100-13153 is used for coding complex repair.
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Coding Simple repair CPT Code 12001
We will just check how to code simple repair with an example of CPT code 12001. The CPT code is used for wound repair of different parts of body with size fewer 2.5 cm or less. The CPT code 12001 description is given below.
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
The documentation in the report should mention the location and size of the wound including their measurement in centimeters and depth. The correct calculation of the sum of the wound lengths and the type of repair, i.e., simple, intermediate, or complex is essential for proper coding and reimbursement. So, be sure with the wound repair, location and size in centimeter to code the correct CPT code for repair. Most of the time the coders are unable to find out what type of repair is done. So, it is very essential the documentation should be very clear with the all these things.
Things to Remember for Coding Wound Repair
Check the wound is superficial or deeper Calculate or sum up the wound size to get a final size in Centimeter Checkout the location of wound on body to filter the cpt codes for repair
If you, filter the above three points, you get a type of repair from first point, wound size in centimeter from second and the location of wound from third. Hence, this three key points will reach you to the correct cpt code.
Hope, you would have learnt the basic difference between wound repairs. Share the article if you liked it.