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 …
Utilizing 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...
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers