© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 12036 refers to the intermediate repair of wounds located on the scalp, axillae, trunk, and/or extremities, specifically for wounds measuring between 20.1 cm and 30.0 cm. This type of repair is characterized by its complexity, as it involves not only the closure of the skin but also the deeper layers of subcutaneous tissue and superficial fascia. The procedure begins with the cleansing of the wound and the administration of a local anesthetic to ensure patient comfort. Following this, the wound is thoroughly inspected to assess the extent of the injury, particularly to determine if deeper layers are involved or if extensive cleaning is necessary due to contamination. During the repair process, a layered closure technique is employed, which may utilize sutures, staples, or tissue adhesive. To minimize tension on the wound and promote optimal healing, the tissues surrounding the wound are often undermined using surgical instruments such as scissors or a scalpel. Control of any bleeding is achieved through chemical means or electrocautery. The deepest layers of the wound are typically closed with absorbable sutures, with the knots being buried to prevent irritation. In some cases, permanent sutures may be used instead. The final step involves closing the superficial layer of the wound, ensuring that the edges are properly aligned and everted to avoid any depression of the scar, which is crucial for aesthetic outcomes. This code is part of a series that categorizes intermediate repairs based on the size of the wound, with specific codes designated for various wound lengths, allowing for precise billing and documentation.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 12036 is indicated for the repair of intermediate wounds located on the scalp, axillae, trunk, and/or extremities that measure between 20.1 cm and 30.0 cm. This type of repair is typically performed when the wound involves deeper layers of subcutaneous tissue and superficial fascia, or when extensive cleaning and removal of particulate matter is necessary due to contamination. The indications for this procedure may include, but are not limited to, traumatic injuries, surgical wounds, or lacerations that require a more complex closure technique to ensure proper healing and minimize scarring.
The procedure for CPT® Code 12036 involves several critical steps to ensure effective wound repair. First, the wound is thoroughly cleansed to remove any debris and contaminants, which is essential for preventing infection. Following this, a local anesthetic is administered to the patient to minimize discomfort during the procedure. Once the area is adequately anesthetized, the wound is inspected to assess its depth and extent. This evaluation is crucial as it determines whether the wound involves deeper layers of subcutaneous tissue and superficial fascia, which would necessitate an intermediate repair. If the wound is found to be heavily contaminated, extensive cleaning and debridement are performed to remove any particulate matter. The next step involves undermining the surrounding tissues using surgical instruments such as scissors or a scalpel. This technique is employed to reduce tension on the wound edges, which is vital for promoting optimal healing and minimizing scarring. Once the tissues are adequately prepared, the closure of the wound begins. The deepest layers are typically closed using absorbable sutures, with the knots buried beneath the skin to prevent irritation. In some cases, permanent sutures may be utilized instead. The final step in the procedure involves closing the superficial layer of the wound. Care is taken to align the wound edges properly and to evert them slightly, which helps to prevent the formation of a depressed scar. This layered closure technique is essential for achieving a satisfactory cosmetic outcome and ensuring the wound heals properly.
After the completion of the procedure associated with CPT® Code 12036, post-procedure care is essential for optimal healing. Patients are typically advised to keep the wound clean and dry, and to monitor for any signs of infection, such as increased redness, swelling, or discharge. Follow-up appointments may be scheduled to assess the healing process and to remove any non-absorbable sutures if used. Patients should also be instructed on how to care for the wound at home, including any specific cleaning techniques or dressing changes that may be necessary. It is important to avoid activities that may strain the wound or cause excessive movement in the area, as this can lead to complications such as wound dehiscence or poor cosmetic outcomes. Overall, proper post-procedure care is crucial for ensuring a successful recovery and minimizing the risk of complications.
| Short Descr | INTMD RPR S/A/T/EXT 20.1-30 | Medium Descr | REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM | Long Descr | Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm | Status Code | Active Code | Global Days | 010 - 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 | Procedure or Service, Multiple Reduction Applies | 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) | P5A - Ambulatory procedures - skin | MUE | 1 | CCS Clinical Classification | 171 - Suture of skin and subcutaneous tissue |
| 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. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | 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 | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2013-01-01 | Changed | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.