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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 extend beyond the superficial layers of the skin. This type of repair is indicated when the wound requires more than just simple closure, as it involves deeper layers of tissue, including 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 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 wound edges. To minimize tension on the wound during healing, the tissues may be undermined using surgical instruments. Control of bleeding is achieved through chemical means or electrocautery. The closure of the deepest layers is typically performed 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 that measure over 30.0 cm in length, distinguishing it from other codes that apply to smaller wound sizes.
© 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, determining if it involves deeper layers of tissue. If the wound is heavily contaminated, additional cleaning may be necessary to prepare it for closure.
Next, the surgeon performs a layered closure of the wound. This involves using sutures, staples, or tissue adhesive to secure the wound edges. To reduce tension on the wound, the tissues may be undermined using surgical scissors or a scalpel, allowing for a more effective closure. During this process, any bleeding is controlled using chemical agents or electrocautery to ensure a clean surgical field.
The deepest layers of the wound are then closed with absorbable sutures, which are designed to dissolve over time, and the knots are buried to prevent irritation to the surrounding tissue. In some cases, permanent sutures may be used instead. Finally, the superficial layer of the wound is closed, with careful attention to aligning and everting the wound edges. This technique is crucial for preventing depression of the scar and promoting optimal cosmetic outcomes.
After the procedure, the patient will typically be monitored for any immediate complications, such as excessive bleeding or signs of infection. Instructions for post-procedure care will be provided, which may include keeping the wound clean and dry, monitoring for any changes in appearance, and recognizing signs of infection. Patients may also be advised on pain management strategies and when to follow up for suture removal or further evaluation. The expected recovery time will vary depending on the individual and the extent of the wound, but proper care is essential for optimal healing and minimizing scarring.
| Short Descr | INTMD RPR N-HF/GENIT >30.0CM | Medium Descr | REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM | Long Descr | Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 |
| 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 | F1 | Left hand, second digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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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