CPT® 2012: You'll Get Closure With Novel Skin Repair Guidelines

Also, don't overlook separate debridement opportunity.

Feeling dazed by all the changes in the CPT 2012 integumentary section? Read this expert medical coding article to keep your skin repair claims clean and earn all the pay you deserve.

Note New Modifier Advice for Repairs

CPT 2012 proposes new introductory notes that offer guidance on how to report skin closures (12001-13160). Though the guidelines earlier advised the use of modifier 51 (Multiple procedures) when reporting dissimilar wound repair classifications together, that guidance is old news as of Jan. 1.

In black and white: The 2012 CPT® manual reads, "When more than one classification of wounds is repaired, list the more complicated as the primary procedure and the less complicated as the secondary procedure, using modifier 59."

What's "complicated? As CPT 2012 proposes simple, intermediate, and complex repairs, you'd think through the "simple" repair the minimum complicated, and the "complex" repair the maximum complicated. Consequently, in case the surgeon closes a leg wound with a simple repair for instance 12001(Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less) and an intermediate repair, for instance 12032 (Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm), you'll report the intermediate repair first, which should be followed by the simple repair with the modifier: 12032, 12001-59.

Know When Debridement is ‘Separate'

When surgeons carries out skin grafting, it's normal for coders to spend a lot of time and work trying to decide whether they can bill debridement distinctly, as a lot of physicians request.

Debridement is taken as a distinct procedure only when gross contamination needs a prolonged cleansing, when considerable amounts of devitalized or contaminated tissue are removed, or when debridement is performed separately without immediate primary closure.

CPT 2012 Tip: Your documentation must fully explain the surgeon's work cleansing the contamination and eliminating the devitalized tissue prior to you distinctly bill your insurer for debridement.

For More Information :-  http://www.supercoder.com/ 

Skin Substitute Coding Renovation Simplifies Processes

Even though you may have been surprised when you saw that CPT 2012 made enormous changes to the skin substitute coding section (15271-15278, Application of skin substitute graft …), you must know that the AMA's goal was to make your life stress-free, not more difficult,

For wounds that are lesser than 100 square centimeters, you'll follow one code structure – in case your wound is 100 square centimeters or greater, you'll follow a different code structure. It has been felt that about 80 percent of the wounds would fit into the ‘less than 100 sq. cm' description.