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Joel Posted Fri 05th of August, 2011 15:52:31 PM



SuperCoder Answered Fri 05th of August, 2011 19:30:11 PM

Wound repairs are classified into three types; simple, intermediate and complex. The CPT book, along with AMA's CPT Assistant and AHA Coding Clinic for HCPCS, contain definitions and information regarding each repair type.
Simple repair codes 12001 - 12021 are used when the wound only involves the epidermis and/or dermis. The wound does not extend into the deeper subcutaneous tissues. The repair is a simple one layer closure and may be performed with the use of tissue adhesives, staples or suture material. . A simple repair reported with code only G0168 will not be reimbursed. The code for the simple repair is assigned from code range 12001-12018 and an additional code for the wound adhesive G0168 may also be assigned.
Intermediate repair codes 12031 – 12057 are used when wound repair requires closure of the subcutaneous tissue beneath the dermis. Intermediate wound repair includes layered closure of the wound and also single layer closure of heavily contaminated wounds, requiring extensive removal of particulate matter. If the deeper layers are closed with suture material and the superficial layer is closed with a tissue adhesive, you may assign two codes, one from code range 12031-12057 for the intermediate repair and G0168 for the use of the tissue adhesive.
Complex repair codes 13100 – 13153 are used for the repair of wounds requiring more than layered closure. Complex repair may involve scar revision, extensive undermining, and placement of stents or retention sutures. These codes also include the layered repair of lacerations that require debridement of the wound edges before the wound can be closed. A wound described as complicated or complex will not necessarily require a complex closure. A physician may label a repair as "complex," however, it must meet the criteria above for a complex repair code to be assigned.

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