Cracking the Code

Coding Repairs

Coding repairs can seem daunting to some; however, the process is laid out nicely in our CPT code books. Our CPT code books have guidelines specifically for repairs. First, we want to understand the difference behind a simple, intermediate and complex repair. A simple repair is a one-layer closure, which can be superficial, epidermis, dermis, or subcutaneous tissue. Simple repairs are primarily used when the wound is superficial. Next is intermediate repair. This is a layered closure including deeper layers of subcutaneous tissue and non-muscle fascia, or a single layered closure of heavily contaminated wounds requiring extensive cleansing or removal of specific matter. Finally, we have a complex repair. Complex repairs require more than a layered closure such as debridement, extensive undermining stents or retention sutures to name a few examples.

When we are coding repairs, we always want to begin with the highest level of repair first. Documentation should include location of the repair, length of the repair, depth in terms of centimeters, description of the appearance, and the type of repair such as simple, intermediate, or complex.

Q: What is the CPT code for an intermediate repair of the trunk that is 3.5cm?
A: 12032. Rationale: In our CPT Index for Repair/Wound/Intermediate guiding us to CPT codes 12031-12057. We find our Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 2.6cm-7.5cm as 12032.
Reference: FY 2023 CPT code book
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