Laceration Repair—Complex

Reconstructive procedures, and complicated wound closure.
The sum of lengths of repairs for each group of anatomic sites. (For full-thickness repair of lip or eyelid, see respective anatomical subsections)

CPT CODE -13100 Repair, complex, trunk; 1.1 cm to 2.5 cm
(For 1.0 cm or less, see simple or intermediate repairs

CPT code 13100 is used for “Repair, complex, trunk; 2.5 cm or less.” This code is typically used when a healthcare provider performs a complex repair of a wound on the trunk area (including the chest and back)

Coding Guidelines:

Correct Procedure: Ensure that the procedure being coded is indeed a “Complex repair of the trunk.” This code is specific to complex repairs of wounds on the trunk area.

Wound Size: Code 13100 is used for wounds that measure 2.5 centimeters or less. Accurately measure the wound to determine its size. If the wound is larger, a different code may be necessary.

Complex Repair: This code is used for complex repairs, which are more involved than simple or intermediate repairs. Complex repairs often involve significant tissue loss or damage, requiring advanced techniques and multiple layers of closure.

Documentation: Proper documentation of the procedure is crucial for coding accuracy. The medical record should include details about the location and size of the wound, the technique used for repair, the complexity of the wound, and any special circumstances or considerations.

Code Modifiers: If there are specific circumstances that affect the procedure or the patient, modifiers may be added to the code for additional information or to indicate special circumstances.

Example:

Let’s consider an example where a patient, Mr. Smith, is involved in a car accident and sustains a complex laceration on his chest. The laceration on his chest measures 2.0 centimeters and needs a complex repair.

Mr. Smith is taken to the emergency department, where a healthcare provider assesses the complex wound on his chest. The provider determines that the laceration on his chest is extensive, involving multiple tissue layers and that it requires a complex repair to ensure proper healing and minimize scarring.

The healthcare provider performs a complex repair to treat the wound on Mr. Smith’s chest. This may involve meticulous layering of sutures and other advanced techniques to reconstruct the wound.

In the medical billing and coding process, the appropriate CPT code for the procedure, 13100, is used to bill for the complex repair of the wound on Mr. Smith’s chest.

CPT CODE – 13101Repair, complex, trunk; 2.6 cm to 7.5 cm

CPT CODE – ✚ 13102 Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure)
(Use 13102 in conjunction with 13101)

CPT CODE – 13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm
(For 1.0 cm or less, see simple or intermediate repairs)

CPT code 13120 is used for “Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm.” This code is typically used when a healthcare provider performs a complex repair of a wound on the scalp, arms, or legs

Coding Guidelines:

Correct Procedure: Ensure that the procedure being coded is indeed a “Complex repair of scalp, arms, and/or legs.” This code is specific to complex repairs of wounds in these specified anatomical areas.

Wound Size: Code 13120 is used for wounds that measure between 1.1 and 2.5 centimeters. Accurately measure the wound to determine its size. If the wound is larger or smaller, a different code may be necessary.

Complex Repair: This code is used for complex repairs, which are more involved than simple or intermediate repairs. Complex repairs often involve significant tissue loss or damage, requiring advanced techniques and multiple layers of closure.

Documentation: Proper documentation of the procedure is crucial for coding accuracy. The medical record should include details about the location and size of the wound, the technique used for repair, the complexity of the wound, and any special circumstances or considerations.

Code Modifiers: If there are specific circumstances that affect the procedure or the patient, modifiers may be added to the code for additional information or to indicate special circumstances.

Example:

Let’s consider an example where a patient, Ms. Johnson, accidentally falls and sustains a complex laceration on her arm. The laceration on her arm measures 2.0 centimeters and needs a complex repair.

Ms. Johnson is taken to the emergency department, where a healthcare provider assesses the complex laceration on her arm. The provider determines that the laceration on her arm is extensive, involving multiple tissue layers and that it requires a complex repair to ensure proper healing and minimize scarring.

The healthcare provider performs a complex repair to treat the wound on Ms. Johnson’s arm. This may involve meticulous layering of sutures and other advanced techniques to reconstruct the wound.

In the medical billing and coding process, the appropriate CPT code for the procedure, 13120, is used to bill for the complex repair of the wound on Ms. Johnson’s arm.

CPT CODE – 13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm

CPT code 13121 is used for “Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 1.1 cm to 2.5 cm.” This code is typically used when a healthcare provider performs a complex repair of a wound on the specified areas (forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, or feet)

Coding Guidelines:

Correct Procedure: Ensure that the procedure being coded is indeed a “Complex repair of forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet.” This code is specific to complex repairs of wounds in these specified anatomical areas.

Wound Size: Code 13121 is used for wounds that measure between 1.1 and 2.5 centimeters. Accurately measure the wound to determine its size. If the wound is larger or smaller, a different code may be necessary.

Complex Repair: This code is used for complex repairs, which are more involved than simple or intermediate repairs. Complex repairs often involve significant tissue loss or damage, requiring advanced techniques and multiple layers of closure.

Documentation: Proper documentation of the procedure is crucial for coding accuracy. The medical record should include details about the location and size of the wound, the technique used for repair, the complexity of the wound, and any special circumstances or considerations.

Code Modifiers: If there are specific circumstances that affect the procedure or the patient, modifiers may be added to the code for additional information or to indicate special circumstances.

Example:

Let’s consider an example where a patient, Mr. Roberts, sustains a complex laceration on his chin in a motor vehicle accident. The laceration on his chin measures 2.0 centimeters and needs a complex repair.

Mr. Roberts is taken to the emergency department, where a healthcare provider assesses the complex laceration on his chin. The provider determines that the laceration on his chin is extensive, involving multiple tissue layers and that it requires a complex repair to ensure proper healing and minimize scarring.

The healthcare provider performs a complex repair to treat the wound on Mr. Roberts’s chin. This may involve meticulous layering of sutures and other advanced techniques to reconstruct the wound.

In the medical billing and coding process, the appropriate CPT code for the procedure, 13121, is used to bill for the complex repair of the wound on Mr. Roberts’s chin.

CPT CODE – ✚ 13122 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure

(Use 13122 in conjunction with 13121

CPT CODE – 13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 1.1 cm to 2.5 cm

(For 1.0 cm or less, see simple or intermediate repairs)

CPT CODE – 13132Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet;  2.6 cm to 7.5 cm

CPT CODE – ✚ 13133 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure)

(Use 13133 in conjunction with 13132)
(For 1.0 cm or less, see simple or intermediate repairs)

CPT CODE – 13151 Repair, complex, eyelids, nose, ears, and/or lips; 1.1 cm to 2.5 cm

CPT code 13151 is used for “Repair, complex, eyelids, nose, ears, and/or lips; 2.6 cm to 5.0 cm.” This code is typically used when a healthcare provider performs a complex repair of a wound on the specified areas (eyelids, nose, ears, or lips)

Coding Guidelines:

Correct Procedure: Ensure that the procedure being coded is indeed a “Complex repair of eyelids, nose, ears, and/or lips.” This code is specific to complex repairs of wounds in these specified anatomical areas.

Wound Size: Code 13151 is used for wounds that measure between 2.6 and 5.0 centimeters. Accurately measure the wound to determine its size. If the wound is larger or smaller, a different code may be necessary.

Complex Repair: This code is used for complex repairs, which are more involved than simple or intermediate repairs. Complex repairs often involve significant tissue loss or damage, requiring advanced techniques and multiple layers of closure.

Documentation: Proper documentation of the procedure is crucial for coding accuracy. The medical record should include details about the location and size of the wound, the technique used for repair, the complexity of the wound, and any special circumstances or considerations.

Code Modifiers: If there are specific circumstances that affect the procedure or the patient, modifiers may be added to the code for additional information or to indicate special circumstances.

Example:

Let’s consider an example where a patient, Ms. Allen, is involved in an accident and sustains a complex laceration on her lower lip. The laceration on her lip measures 3.5 centimeters and needs a complex repair.

Ms. Allen is taken to the emergency department, where a healthcare provider assesses the complex laceration on her lower lip. The provider determines that the laceration on her lip is extensive, involving multiple tissue layers and that it requires a complex repair to ensure proper healing and minimize scarring.

The healthcare provider performs a complex repair to treat the wound on Ms. Allen’s lower lip. This may involve meticulous layering of sutures and other advanced techniques to reconstruct the wound.

In the medical billing and coding process, the appropriate CPT code for the procedure, 13151, is used to bill for the complex repair of the wound on Ms. Allen’s lower lip.

CPT CODE – 13152 Repair, complex, eyelids, nose, ears, and/or lips; 2.6 cm to 7.5 cm

CPT CODE – ✚ 13153 Repair, complex, eyelids, nose, ears, and/or lips;  each additional 5 cm or less (List separately in addition to code for primary procedure)

(Use 13153 in conjunction with 13152

CPT CODE – 13160 Secondary closure of surgical wound or dehiscence, extensive or complicated

(Do not report 13160 in conjunction with 11960) (For packing or simple secondary wound closure, see 12020, 12021)

CPT code 13160 is used for “Secondary closure of surgical wound or dehiscence, extensive or complicated.” This code is typically used when a healthcare provider performs a secondary closure of a surgical wound or dehiscence that is extensive or complicated, requiring more than a simple closure.

Coding Guidelines:

Correct Procedure: Ensure that the procedure being coded is indeed a “Secondary closure of surgical wound or dehiscence, extensive or complicated.” This code is specific to secondary closures of wounds that are extensive or complicated.

Extent and Complexity: Code 13160 is used when the secondary closure is extensive or complicated, meaning that it involves significant tissue loss or damage and requires advanced techniques and multiple layers of closure.

Documentation: Proper documentation of the procedure is crucial for coding accuracy. The medical record should include details about the location and size of the wound, the reason for the dehiscence, the technique used for repair, and any special circumstances or considerations.

Code Modifiers: If there are specific circumstances that affect the procedure or the patient, modifiers may be added to the code for additional information or to indicate special circumstances.

Example:

Let’s consider an example where a patient, Mr. Johnson, underwent abdominal surgery to remove a tumor. After the surgery, a portion of the incision site experiences dehiscence, where the wound partially opens up, and the tissue layers are exposed. The dehiscence is extensive and requires secondary closure.

Mr. Johnson returns to the hospital for a follow-up appointment, where a healthcare provider assesses the extensive dehiscence at the surgical incision site. The provider determines that the dehiscence is complicated, involving multiple tissue layers and that it requires a secondary closure to ensure proper healing and minimize scarring.

The healthcare provider performs a secondary closure to treat the dehiscence at the surgical incision site. This may involve meticulous layering of sutures and other advanced techniques to reconstruct the wound.

In the medical billing and coding process, the appropriate CPT code for the procedure, 13160, is used to bill for the secondary closure of the extensive and complicated dehiscence at the surgical incision site.

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