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Shelly Posted Thu 09th of November, 2017 18:43:07 PM
is there other codes for 12001, 12002, 12004? Insurance is denying 12001 is there any similar codes? what can possibly be the cause of the denial?
SuperCoder Answered Fri 10th of November, 2017 01:09:55 AM

Hi Shelly,

Simple repairs are considered to be part of any surgical procedures performed. However, if repair is performed on different site we can bill it with modifier 59. If modifier is not used, payer consider simple repair as integral part of other major procedure performed.

Also simple repair involves primarily epidermis or dermis, with single layer closure. You may check with the medical records, if it is deeper than dermis and involves multiple layer closure then go for intermediate or complex closure accordingly. Please feel free to ask for further query.

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