tci ED Coding & Reimbursement Alert - 2016 Issue 3

Reader Question: Location And Extent Of Closure Are Key When Coding Oral Laceration Repairs

Question: Should I be coding an intermediate repair (12011) for a laceration in a patient’s mouth since it involves the face and mucous membranes or should I use code 40830 based on the location? Oklahoma Subscriber Answer: CPT® instructs to report the code that accurately describes the service provided, in this case 40830 (Closure of laceration, vestibule of mouth; 2.5 cm or less).  Your other code suggestion, 12011 (Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less), does appear to describe the simple layered closure of...

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