Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
RedactPHI
HIPAA-Compliant PHI Redaction
DetectICD10CM
ICD-10-CM Code Detection
Log in Register free account
1 code page views remaining. Guest accounts are limited to 1 page view. Register free account to get 5 more views.
Log in Register free account

Official Description

Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Intermediate repair of wounds located on the neck, hands, feet, and/or external genitalia involves a surgical procedure designed to address injuries that penetrate deeper than the skin's surface. This type of repair is necessary when the wound affects the subcutaneous tissue and superficial fascia, which are layers beneath the skin that provide support and structure. The procedure begins with the cleansing of the wound to prevent infection, followed by the administration of a local anesthetic to ensure patient comfort during the repair process. The physician inspects the wound to assess its depth and extent, determining if it requires extensive cleaning or removal of debris, especially in cases of contamination. A layered closure technique is then employed, which may involve the use of sutures, staples, or tissue adhesive to secure the wound edges. To minimize tension on the wound and promote optimal healing, the tissues may be undermined using surgical instruments. Control of any bleeding is achieved through chemical means or electrocautery. The closure process involves carefully stitching the deepest layers with absorbable sutures, ensuring that the knots are buried to reduce irritation. The superficial layer is then closed with attention to aligning and everting the wound edges, which is crucial for preventing scar depression. This procedure is specifically coded as CPT® Code 12041 for wounds measuring 2.5 cm or less, with additional codes available for larger wounds, reflecting the complexity and extent of the repair required.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The intermediate repair of wounds of the neck, hands, feet, and/or external genitalia is indicated for various conditions that necessitate surgical intervention. These include:

  • Wounds requiring deeper closure - Wounds that penetrate beyond the skin into the subcutaneous tissue and superficial fascia.
  • Contaminated wounds - Wounds that are heavily contaminated and require extensive cleaning and removal of particulate matter.
  • Wounds with significant tissue loss - Injuries that involve loss of tissue integrity and necessitate a layered closure to promote proper healing.

2. Procedure

The procedure for intermediate repair of wounds involves several critical steps to ensure effective closure and healing. Each step is designed to address the specific needs of the wound:

  • Step 1: Wound Cleansing - The first step involves thoroughly cleansing the wound to remove any debris and reduce the risk of infection. This is a crucial preparatory step that sets the stage for a successful repair.
  • Step 2: Anesthesia Administration - A local anesthetic is administered to the patient to ensure comfort during the procedure. This allows the physician to perform the repair without causing pain to the patient.
  • Step 3: Wound Inspection - The physician inspects the wound to assess its depth and extent. This evaluation determines whether the wound involves deeper layers of tissue and if extensive cleaning is necessary.
  • Step 4: Tissue Undermining - If required, the tissues surrounding the wound are undermined using scissors or a scalpel. This technique helps to minimize tension on the wound edges during closure, which is essential for optimal healing.
  • Step 5: Bleeding Control - Any bleeding is controlled using chemical agents or electrocautery. This step is vital to ensure a clear surgical field and to prevent complications during the repair.
  • Step 6: Layered Closure - The deepest layers of the wound are closed using absorbable sutures, with the knots buried to avoid irritation. This layered approach provides strength and support to the wound as it heals.
  • Step 7: Superficial Layer Closure - Finally, the superficial layer of the wound is closed, ensuring that the edges are aligned and everted. This careful alignment is crucial to prevent scar depression and promote aesthetic healing.

3. Post-Procedure

After the procedure, the patient may require specific post-operative care to ensure proper healing. This includes monitoring the wound for signs of infection, keeping the area clean and dry, and following any additional instructions provided by the healthcare provider. Patients may also be advised on pain management and activity restrictions to facilitate recovery. Regular follow-up appointments may be necessary to assess the healing process and to remove any non-absorbable sutures if used. Overall, adherence to post-procedure care is essential for optimal outcomes and to minimize complications.

Short Descr INTMD RPR N-HF/GENIT 2.5CM/<
Medium Descr REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<
Long Descr Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less
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 T-Packaged Codes
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
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).
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.
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.)
LT Left side (used to identify procedures performed on the left side of the body)
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.)
GC This service has been performed in part by a resident under the direction of a teaching physician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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.
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.
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.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CG Policy criteria applied
CR Catastrophe/disaster related
ER Items and services furnished by a provider-based, off-campus emergency department
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
GA Waiver of liability statement issued as required by payer policy, individual case
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
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
TA Left foot, great toe
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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.
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"