A patient had two wounds repaired: trunk 12.4 cm and right leg 6.1 cm (intermediate repair), plus a complex repair of the left eyelid measuring 3.5 cm. What are the correct CPT codes?

A patient had two wounds repaired: trunk 12.4 cm and right leg 6.1 cm (intermediate repair), plus a complex repair of the left eyelid measuring 3.5 cm. What are the correct CPT codes?

• A. 12031,13152-51
• B. 12032,13152-54
• C. 12035,13152-51
• D. 12034,13152-50

Answer: (C)

Wound repair coding uses the repair’s complexity and the anatomic location to choose the appropriate code. When more than one wound is repaired in a single encounter, you report one code for the most extensive repair and then report any additional repairs on other sites with separate codes, using modifiers to show there were multiple procedures. In this case, the two wounds on the trunk and leg are of intermediate complexity. They’re treated in one session with a repair coded at the intermediate level, which corresponds to the code used for that category of wounds. The left eyelid wound, at 3.5 cm, requires a higher-complexity repair, so it gets its own distinct code for a complex eyelid repair. Thus, the trunk/leg wounds are coded with the intermediate repair code 12035, and the complex eyelid repair is coded with 13152. Since these are two procedures performed in the same session, the eyelid repair code carries the modifier that indicates multiple procedures (−51): 13152−51. Modifiers such as −54 or −50 aren’t appropriate here—the first denotes surgical care only or bilateral procedures in different contexts, and the −51 is the proper way to reflect multiple procedures performed in one encounter.

Wound repair coding uses the repair’s complexity and the anatomic location to choose the appropriate code. When more than one wound is repaired in a single encounter, you report one code for the most extensive repair and then report any additional repairs on other sites with separate codes, using modifiers to show there were multiple procedures.

In this case, the two wounds on the trunk and leg are of intermediate complexity. They’re treated in one session with a repair coded at the intermediate level, which corresponds to the code used for that category of wounds. The left eyelid wound, at 3.5 cm, requires a higher-complexity repair, so it gets its own distinct code for a complex eyelid repair.

Thus, the trunk/leg wounds are coded with the intermediate repair code 12035, and the complex eyelid repair is coded with 13152. Since these are two procedures performed in the same session, the eyelid repair code carries the modifier that indicates multiple procedures (−51): 13152−51.

Modifiers such as −54 or −50 aren’t appropriate here—the first denotes surgical care only or bilateral procedures in different contexts, and the −51 is the proper way to reflect multiple procedures performed in one encounter.