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Wound Closure Coding: Make the Simple, Intermediate Distinction

Posted on 21. Jan, 2010 by in Hot Coding Topics

Accounting for depth is a tricky task when coding closure.

Practices interested in ethically boosting their bottom line and getting $80 or more for the same closure repair need to walk the line that separates simple from intermediate.

What Makes a Repair “Simple”?

A wound closure is a simple repair if the procedure:

  • is simple;
  • is a single-layer closure involving the epidermis, dermis, or subcutaneous tissues; and
  • does not involve deeper structures.

Code these closures with 12001-12021, confirms Dilsia Santiago, CCS, CCS-P, a coder in Reading, Pa. And remember that simple repair includes “local anesthesia, and chemical or electrocauterization of wounds not closed,” she continues.

Example: The ED physician examines a 22-year-old patient’s scalp wound …

trans.gifUtilizing prolene sutures the physician closes a 2.3 cm single-layer wound. On the claim, you’d report 12001 (Simple repair of wounds of scalp, neck, axillae, external...

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