When your dermatologist closes a wound, your first instinct is to select the repair codes (12001– 13006). However, if the documentation shows that the dermatologist performed a tissue transfer (14000–14302), those codes might be more appropriate, and more lucrative. Follow these three steps to make sure you’re coding accurately, ethically, and profitably.
1. Learn the Difference Between Transfers and Repairs
For wound closure procedures, you’ll first need to decide between wound repair codes 12001–13160 and adjacent tissue transfer codes 14000–14302 (Adjacent tissue transfer or rearrangement …).
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The basics: In simplest terms, if your surgeon only cleans and sutures the wound you’ll choose a simple, intermediate, or complex repair code (12001–13160).
Caution: Intermediate and complex repairs may require freeing tissue as well, says Pamela Biffle, CPC, CPC-P, CPC-I, CCS-P, CHCC, CHCO, owner of PB Healthcare Consulting and Education Inc. in Austin, Texas. “What the average coder needs to look for is the word ‘plasty’ or ‘flap,’” she says.
If the documents suggest that the surgeon freed tissue from around the wound and rearranged it to cover and repair the wound area, it’s a case of tissue transfer and you need to turn to 14000–14300.
The wound repair/closure CPT® codes 12001–13160 describe direct wound closure employing sutures, staples, or tissue adhesives (cyanoacrylate), say experts. The tissue transfer CPT® codes 14000–14302 are used for the repair of traumatic wounds and for the excision of a lesion (benign or malignant) and the repair of the resulting “primary defect” (and the resulting “secondary defect”) by adjacent tissue transfer or rearrangement (including Z-plasty, W-Plasty,...
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