Coding Education: Simple, Intermediate or Complex Closure?

Posted on 29. Sep, 2009 by Editor in Hot Coding Topics

Correctly distinguish closure levels every time with this advice from the experts.

All closures aren’t created equal; one of the nuances of coding these procedures is knowing how to distinguish one type from another. Read on for our experts’ advice on how to assess the three closure levels and assign the best codes.

Remember ‘Simple’ Doesn’t Mean ‘Easy’

A simple repair involves primarily the dermis and epidermis. It might involve subcutaneous tissues, but not deep layers.

Draw the line: How do you know when a closure might involve subcutaneous layers but is still considered a simple repair? Your provider’s documentation is the key. “The difference is whether the wound is closed in layers or just a single layer,” says Kevin Arnold, BHA, CPC, business manager for the Emergency Medicine Department at Norwalk Hospital in Norwalk, Conn. “The provider might decide to include the subcutaneous layer in the closure but does so by bringing the needle through the dermis into the subcutaneous and back. That results in a single-layer closure rather than closing the subcutaneous layer first and then the dermis/epidermis second in separate closure techniques.”

LEARNING OPPORTUNITY: John Bishop’s can be on your telephone Thursday, October 15 to teach your entire office about coding and billing for lesion removal.

For example, if your dermatologist uses adhesive strips to close a laceration, consider it an E/M service that you’ll report with the best-fitting choice from codes 99201-99205 (Office or other outpatient visit for the evaluation and management of a new patient …) or 99211-99215 (Office or other outpatient visit for the evaluation and management of an established patient …).

“Most steri-strip applications are done...

Tags: closure, complex, intermediate, simple