tci General Surgery Coding Alert - 2004 Issue 3

Reader Question: For Adhesive Strips Alone, Use E/M

Question: Recently, a payer rejected a claim for wound repair (12005) using a combination of stitches and adhesive strips. We carefully documented the wound length(s). What's the problem?North Carolina Subscriber Answer: Your payer may be confusing CPT's rules regarding tissue adhesive. Wound closure codes 12001-13160 "designate closure utilizing sutures, staples or tissue adhesive (e.g., 2-cyanoacrylate), either singly or in combination with each other, or in combination with adhesive strips" [emphasis added], according to CPT. In other words, if the surgeon applies any tissue adhesive or places a single stitch or staple, the wound care codes are...

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