It is my understanding that when coding keloid scar revision you should use a complex repair code and not an excision code plus the repair. Is this correct? Patient had a 12 cm ulcerated keloid scar excised from abdominal wall. (13101 and 13102)
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Resolved Keloid Scar Revision
- Thread starter KathyP_3146
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Lori
Well-known member
Yes & here is an article you may have seen that confirms this.
Most coders seem to choose a diagnosis of hypertrophic scar (L91. 0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate repair) for the procedure but scar revision is different.
Scar revision is mentioned specifically under complex repair.
Most coders seem to choose a diagnosis of hypertrophic scar (L91. 0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate repair) for the procedure but scar revision is different.
Scar revision is mentioned specifically under complex repair.
- Complex repairs (13100-13160) treat deeper, more extensive wounds that require more than a layered closure such as debridement, extensive undermining, stents, scar revision, or retention sutures. Complex repairs include wounds that necessitate the creation of a limited defect for repairs or the debridement of complicated avulsions or lacerations. Documentation should detail extensive reconstructive repair necessitating procedures more involved than cleansing and suturing at one or more levels.
- Complex repair includes the repair of wounds requiring more than layered closure, viz., scar revision, debridement (eg, traumatic lacerations or avulsions), extensive undermining, stents or retention sutures. Necessary preparation includes creation of a limited defect for repairs or the debridement of complicated lacerations or avulsions. Complex repair does not include excision of benign (11400-11446) or malignant (11600-11646) lesions, excisional preparation of a wound bed (15002-15005) or debridement of an open fracture or open dislocation.
CPT says for scar revision to use a complex repair code such as 13100-13102. Do not use the benign lesion removal and intermediate repair code combination (11404 and 12034)Excision of Scar - KarenZupko&Associates, Inc.
Patient comes in for what they are calling scar revision and the note states that "standing cutaneous excess of the left abdominal scar” was sharply excised. We are billing with a diagnosis of hypertrophic scar (L91.0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate...
www.karenzupko.com
WhitneyH_24046
Well-known member
Great info Lori!
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