What is intermediate repair of wound (2.5 cm or less)?
CPT code 12031 is used for the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 2.5 cm or less in size.
This code applies when a wound requires layered closure, meaning deeper layers such as the dermis are repaired in addition to the skin surface. It represents an intermediate repair of superficial wounds that are more involved than simple closures but do not require the complexity of a complex repair.
Accurate coding is important for proper reimbursement and reflects the clinical judgment, time, and technique needed to ensure optimal wound healing.
CPT code 12031 documentation requirements
Clinical documentation must include:
- Exact anatomic location of the wound
- Length of the wound in centimeters (2.5 cm or less)
- Type of closure: layered closure or extensive wound cleansing
- Wound complexity and contamination status
- Materials used (e.g., suture type)
- Tolerance of the procedure and post-procedure instructions
Include anesthesia type if relevant and ensure all operative elements are clearly charted by the qualified health care professional. This intermediate wound repair code may sometimes need an assistant surgeon is required due to wound depth or anatomical location.
CPT code 12031 billing guidelines
Keep in mind the following to avoid denials and delays in reimbursement:
- If multiple procedures involve repair at the same site, add lengths together and report a single CPT code based on total length.
- Cannot be reported with complex repair or simple wound repair code for the same anatomic site.
- Use modifier 59 if billing for an unrelated procedure or service during the same session on different anatomical locations.
- Local anesthesia is included in the code and not billed separately. The repair involves layered closure of superficial wounds, often extending into deeper layers but not to the level of muscle or bone.
Other relevant CPT codes
- 12032 - Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet), 2.6 cm to 7.5 cm
- 12034 - Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet), 7.6 cm to 12.5 cm
- 12035 - Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet), 12.6 cm to 20.0 cm
- 12036 - Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet), 20.1 cm to 30.0 cm
- 12037 - Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet), over 30.0 cm
Frequently asked questions
CPT code 12031 covers intermediate laceration repair involving layered closure of wounds to the scalp, axillae, trunk, and/or extremities, excluding the hands, feet, and external genitalia. It involves closure of the subcutaneous tissue and skin but does not apply to more complex anatomical sites.
An assistant surgeon may be reported with CPT code 12031 if medically necessary, especially in cases where wound complexity or patient condition justifies additional support. Documentation must clearly reflect the need and role of the assistant surgeon for payer review.
A physician or other qualified healthcare professional can perform intermediate laceration repair under CPT code 12031, provided they are trained in layered wound closure.
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