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The CPT® Code 12016 refers to the simple repair of superficial wounds located on the face, ears, eyelids, nose, lips, and/or mucous membranes, specifically for wounds measuring between 12.6 cm and 20.0 cm. This procedure involves a straightforward approach to wound closure, which is essential for ensuring proper healing and minimizing scarring. During the procedure, the healthcare provider begins by cleansing the wound to prevent infection and then administers a local anesthetic to ensure patient comfort. The wound is carefully inspected to confirm that it is superficial, meaning it only affects the outer layers of skin, such as the epidermis and dermis, or the subcutaneous tissue, without penetrating deeper tissues or exhibiting heavy contamination. The closure of the wound is performed using a simple, one-layer technique, which may involve sutures, staples, or tissue adhesive. These methods can be utilized individually or in combination, including the potential use of adhesive strips to enhance the closure. However, it is important to note that certain methods, such as chemical cautery, electrocautery, or the use of adhesive strips alone, do not qualify as a simple repair closure and should be reported as part of an evaluation and management service instead. This code is part of a series of codes that categorize simple repairs based on the size of the wound, with specific codes designated for various wound sizes, ensuring accurate coding and billing for the services rendered.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 12016 is indicated for the treatment of superficial wounds that occur on the face, ears, eyelids, nose, lips, and/or mucous membranes. These wounds may arise from various causes, including but not limited to, lacerations, abrasions, or minor trauma. The specific indications for performing a simple repair include:
The procedure for CPT® Code 12016 involves several key steps to ensure effective wound repair. The steps are as follows:
After the completion of the procedure, the patient may be given specific post-procedure care instructions to promote healing and prevent complications. This may include guidance on keeping the wound clean and dry, monitoring for signs of infection, and instructions on when to return for follow-up care or suture removal if applicable. The expected recovery time will vary depending on the individual and the nature of the wound, but generally, patients can expect a straightforward recovery process with minimal complications if proper care is followed.
| Short Descr | RPR FE/E/EN/L/M 12.6-20.0 CM | Medium Descr | SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM | Long Descr | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 1 | CCS Clinical Classification | 171 - Suture of skin and subcutaneous tissue |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | FS | Split (or shared) evaluation and management visit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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