CPT guidelines, the laceration repair codes should be reported when a provider performs a wound closure using sutures, staples, or tissue adhesives (e.g., Dermabond®) either alone, in combination with each other, or together with adhesive strips. Further, as per CPT, the repaired wound(s) should be measured and documented in centimeters, regardless of whether the repair is curved, angular, or stellate (star-shaped). The CPT Manual classifies laceration repair codes according to three types of repair: simple, intermediate, and complex:
For laceration repairs with adhesive strips as the sole repair material, you should not report a separate CPT code. Instead, you should report it as part of the evaluation and management (E/M) service.
G0168: Wound closure using tissue adhesive when billing to Medicare
- Simple repair (CPT codes 12001 – 12021): A simple wound repair code is used when the wound is superficial, primarily involving the epidermis, dermis, or subcutaneous tissues without significant involvement of deeper structures where only one layer of closure is necessary using sutures, staples, tissue adhesive, or other closure materials. A simple repair can be billed for chemical and electrocauterization of wounds not closed and include local anesthesia.
- Intermediate repair (CPT codes 12031 – 12057) : An intermediate wound repair code includes the repair of a wound that, in addition to the requirements for simple repair, involves a layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia in addition to the skin (epidermal and dermal) closure. The single-layer closure of a heavily contaminated wound that requires extensive cleaning or removal of particulate matter may also be considered an intermediate repair. Thus, an intermediate repair may be coded if the physician performed a layered closure or a single-layered closure that required extensive debridement.
- Complex repair (CPT codes 13100 – 13160): This includes repairs that require more than layered closure, such as scar revision, debridement of traumatic lacerations or avulsions, extensive undermining, stents, or retention sutures. It may also include the excision of a scar requiring a complex repair or debridement and the repair of complicated lacerations or avulsions.
When coding for wound repairs, you should consider these three components:
- Layer: The depth or complexity of the wound repair
- Location: Where on the body the wound is
- Length: How long in centimeters the wound repair is
For laceration repairs with adhesive strips as the sole repair material, you should not report a separate CPT code. Instead, you should report it as part of the evaluation and management (E/M) service.
G0168: Wound closure using tissue adhesive when billing to Medicare