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A complex repair of a wound of the trunk involves a detailed and meticulous surgical procedure aimed at addressing wounds that are larger and more complicated than simple closures. This type of repair is necessary when the wound requires more than just a layered closure, indicating that the injury may involve deeper tissues or significant tissue loss. 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 operation. The surgeon inspects the wound to assess its complexity and determine the appropriate repair technique. In cases where the procedure is performed for scar revision, the existing scar tissue is excised to allow for a more aesthetically pleasing result. For traumatic lacerations or avulsions, the wound is thoroughly cleansed, and any foreign materials are removed. Debridement may be performed using sharp dissection to prepare the wound for closure. The surgeon may also undermine the surrounding tissues to reduce tension on the wound edges, which is crucial for optimal healing and minimizing scarring. Control of bleeding is achieved through chemical means or electrocautery. The closure technique varies based on the wound's location and nature; deeper layers may be closed with absorbable sutures, while superficial layers are typically closed with non-absorbable sutures. In some cases, retention sutures may be employed to hold the wound edges together without exerting tension, utilizing plastic or rubber tubing to facilitate this process. Additionally, stents may be used to maintain tissue alignment or keep an orifice open. Throughout the procedure, careful attention is given to aligning the wound edges to prevent complications such as scar depression. This code, CPT® 13101, specifically applies to complex repairs of trunk wounds measuring between 2.6 cm and 7.5 cm in length, distinguishing it from other related codes for different wound sizes.
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The complex repair of a wound of the trunk, coded as CPT® 13101, is indicated for specific conditions and scenarios where the wound presents complexities that necessitate advanced surgical techniques. The following are the primary indications for this procedure:
The procedure for a complex repair of a trunk wound involves several critical steps to ensure effective closure and optimal healing. The following outlines the procedural steps involved:
After the complex repair procedure is completed, the patient will require specific post-procedure care to promote healing and prevent complications. The surgeon will provide instructions regarding wound care, which may include keeping the area clean and dry, monitoring for signs of infection, and avoiding activities that could stress the wound. Follow-up appointments will be necessary to assess the healing process and remove sutures if non-absorbable sutures were used. Patients may also be advised on scar management techniques to improve the cosmetic outcome of the repair. Overall, the recovery period will vary based on the individual and the complexity of the wound, but careful adherence to post-procedure guidelines is essential for optimal recovery.
Short Descr | CMPLX RPR TRUNK 2.6-7.5 CM | Medium Descr | REPAIR COMPLEX TRUNK 2.6-7.5 CM | Long Descr | Repair, complex, trunk; 2.6 cm to 7.5 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) | P5A - Ambulatory procedures - skin | MUE | 1 | CCS Clinical Classification | 171 - Suture of skin and subcutaneous tissue |
This is a primary code that can be used with these additional add-on codes.
13102 | Addon Code MPFS Status: Active Code APC N ASC N1 CPT Assistant Article Illustration for Code Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure) | 20701 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure) |
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.) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | RT | Right side (used to identify procedures performed on the right side of the body) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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 | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 56 | Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AG | Primary physician | 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 | ET | Emergency services | F2 | Left hand, third digit | F7 | Right hand, third digit | FA | Left hand, thumb | FT | Unrelated evaluation and management (e/m) visit on the same day as another e/m visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated) | 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 | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | SA | Nurse practitioner rendering service in collaboration with a physician | SU | Procedure performed in physician's office (to denote use of facility and equipment) | 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 |
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