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Intermediate repair of wounds located on the neck, hands, feet, and/or external genitalia involves a surgical procedure designed to address wounds that penetrate deeper layers of tissue. This type of repair is indicated when the wound requires more than just simple closure, as it involves the 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 carefully inspected to assess the extent of the injury, particularly if it involves significant contamination or requires extensive cleaning. The repair process includes a layered closure technique, which may utilize sutures, staples, or tissue adhesive to secure the tissue layers effectively. To minimize tension on the wound, the surrounding tissues may be 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 employed. The final step involves closing the superficial layer of the wound, ensuring that the edges are properly aligned and everted to promote optimal healing and minimize scarring. This procedure is specifically applicable for wounds measuring between 7.6 cm and 12.5 cm in length, and it is important to select the appropriate CPT® code based on the size of the wound, with specific codes designated for varying lengths of wounds.
© Copyright 2025 Coding Ahead. All rights reserved.
The intermediate repair of wounds of the neck, hands, feet, and/or external genitalia is indicated for the following conditions:
The procedure for intermediate repair of wounds involves several critical steps to ensure proper healing and minimize complications. 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 ensure comfort during the procedure. Once the area is numb, the surgeon inspects the wound to assess its depth and extent, particularly looking for involvement of deeper tissues. If the wound is determined to require a more complex repair, the next step involves undermining the surrounding tissues using scissors or a scalpel. This technique helps to reduce tension on the wound edges, which is crucial for optimal healing. After undermining, any bleeding is controlled using chemical agents or electrocautery to minimize blood loss. The closure of the wound is performed in layers, starting with the deepest layers, which are typically closed with absorbable sutures. The knots of these sutures are buried to prevent irritation to the skin. The superficial layer of the wound is then closed, ensuring that the edges are aligned and everted. This alignment is important to prevent the formation of a depressed scar. The use of sutures, staples, or tissue adhesive may vary based on the surgeon's preference and the specific characteristics of the wound.
After the intermediate repair procedure, patients are typically monitored for any immediate complications, such as excessive bleeding or signs of infection. Instructions for post-procedure care are provided, which may include keeping the wound clean and dry, monitoring for any changes in appearance, and avoiding activities that could stress the wound. Follow-up appointments may be scheduled to assess healing and remove any non-absorbable sutures if used. Patients are advised to report any signs of infection, such as increased redness, swelling, or discharge from the wound site. Overall, the expected recovery time will vary based on the individual and the specific characteristics of the wound, but proper care and adherence to post-procedure instructions are essential for optimal healing.
| Short Descr | INTMD RPR N-HF/GENIT7.6-12.5 | Medium Descr | REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM | Long Descr | Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 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) | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 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.) | 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 | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | F1 | Left hand, second digit | F2 | Left hand, third 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 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | 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) | SG | Ambulatory surgical center (asc) facility service | T1 | Left foot, second digit | UD | Medicaid level of care 13, as defined by each state | 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 | 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 |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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