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A complex repair of a wound involves a detailed and meticulous approach to treating injuries located on specific areas of the body, including the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. This procedure is necessary when a wound requires more than a simple layered closure, indicating that the injury is more extensive or complicated. The process begins with the cleansing of the wound to remove any debris or contaminants, followed by the administration of a local anesthetic to ensure patient comfort during the procedure. Upon inspection, if the wound is determined to necessitate a complex repair, the surgeon may excise any existing scar tissue if the procedure is aimed at scar revision. In cases of traumatic lacerations or avulsions, the wound is thoroughly cleansed, and any particulate matter is removed to promote healing. Debridement may be performed using sharp dissection techniques to remove non-viable tissue. To minimize tension on the wound during closure, extensive undermining of the surrounding tissues may be carried out. Hemostasis is achieved through chemical means or electrocautery to control any bleeding. The closure technique varies based on the wound's location and nature; deeper layers may be closed with absorbable sutures, while non-absorbable sutures are typically used for the superficial layers. Retention sutures may be employed to hold the wound edges together without exerting tension, utilizing a method where a short length of plastic or rubber tubing is threaded over each suture before tying. Additionally, stents may be utilized to maintain tissue alignment or to keep an orifice open. Throughout the procedure, careful attention is given to align the edges of the wound accurately to prevent complications such as scar depression. For coding purposes, the add-on code 13133 is used for each additional 5 cm or less of wound length when the primary repair exceeds 7.5 cm, while codes 13131 and 13132 are designated for primary repairs of specific lengths.
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The complex repair procedure is indicated for the following conditions:
The procedure for complex repair involves several critical steps to ensure effective treatment of the wound:
After the complex repair procedure, the patient will require specific post-procedure care to ensure optimal healing. This may include instructions on wound care, signs of infection to monitor, and follow-up appointments to assess healing progress. Patients are typically advised to keep the area clean and dry, and to avoid any activities that may stress the wound. The healthcare provider may also schedule follow-up visits to remove sutures if non-absorbable sutures were used and to evaluate the cosmetic outcome of the repair.
| Short Descr | CMPLX RPR F/C/C/M/N/AX/G/H/F | Medium Descr | REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/< | Long Descr | Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No 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 | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 7 | CCS Clinical Classification | 171 - Suture of skin and subcutaneous tissue |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 13132 | MPFS Status: Active Code APC T ASC A2 CPT Assistant Article Illustration for Code Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm | 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) |
| 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.) | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | LT | Left side (used to identify procedures performed on the left side of the body) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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). | 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.) | 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). | 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 | F3 | Left hand, fourth digit | F6 | Right hand, second digit | F7 | Right hand, third digit | F8 | Right hand, fourth digit | FA | Left hand, thumb | GA | Waiver of liability statement issued as required by payer policy, individual case | GJ | "opt out" physician or practitioner emergency or urgent service | 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 | RT | Right side (used to identify procedures performed on the right side of the body) | T8 | Right foot, fourth digit | TA | Left foot, great toe | 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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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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