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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 injuries that penetrate deeper than the skin's surface. This type of repair is necessary when the wound requires more than simple closure, as it involves the subcutaneous tissue and superficial fascia. 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 surgeon inspects the wound to assess its depth and extent, determining if it necessitates extensive cleaning or removal of debris, particularly in cases of contamination. A layered closure technique is employed, which may include the use of sutures, staples, or tissue adhesive to secure the tissue layers effectively. To minimize tension on the wound and promote optimal healing, the tissues are undermined, allowing for better alignment and closure. Control of bleeding is achieved through chemical means or electrocautery. The deepest layers of the wound are typically closed with absorbable sutures, with the knots buried to reduce irritation. In some cases, permanent sutures may be utilized. The final step involves closing the superficial layer of the wound, ensuring that the edges are properly aligned and everted to prevent the formation of a depressed scar. This procedure is specifically indicated for wounds measuring between 20.1 cm and 30.0 cm, with specific CPT codes designated for varying wound sizes, allowing for accurate medical coding and billing.
© 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 reduce the risk of infection. Following this, a local anesthetic is administered to numb the area, allowing the patient to remain comfortable throughout the procedure. The surgeon then inspects the wound to evaluate its depth and extent, confirming that it involves deeper layers of tissue. If the wound is heavily contaminated, additional cleaning may be necessary to remove any foreign materials. Once the wound is prepared, a layered closure technique is employed. This involves undermining the tissues using scissors or a scalpel to relieve tension on the wound edges, which is crucial for optimal healing. Bleeding is controlled using chemical agents or electrocautery to ensure a clean surgical field. The deepest layers of the wound are closed with absorbable sutures, with the knots buried to prevent irritation. In some cases, permanent sutures may be used instead. Finally, the superficial layer of the wound is closed, ensuring that the edges are aligned and everted to prevent the formation of a depressed scar. This meticulous approach is essential for achieving a satisfactory cosmetic outcome and promoting effective healing.
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, changing dressings as directed, and avoiding activities that could stress the repair site. Patients are advised to watch for any signs of infection, such as increased redness, swelling, or discharge. Follow-up appointments may be scheduled to assess the healing process and remove any non-absorbable sutures if used. The expected recovery time can vary based on the individual and the specific characteristics of the wound, but patients are generally encouraged to resume normal activities as tolerated while adhering to any specific restrictions provided by their healthcare provider.
| Short Descr | INTMD RPR N-HF/GENIT20.1-30 | Medium Descr | RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM | Long Descr | Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 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) | 0 - 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 |
| 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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 | 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) | 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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