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The procedure described by CPT® Code 40652 involves a full-thickness repair of the lip, specifically addressing injuries that affect up to half of the vertical height of the lip. The lips are anatomically divided into three distinct regions: the cutaneous, vermilion, and mucosal areas. The cutaneous region encompasses the outer skin of the lip, while the vermilion region is the pinkish-red area that is more delicate and composed of modified mucosal membrane. The mucosal portion is located inside the mouth and is adjacent to the teeth. In the context of this procedure, a full-thickness repair means that all layers of the lip, including skin, muscle, and mucosa, are involved in the repair process. The surgical technique requires careful alignment of the vermilion border to ensure aesthetic outcomes, and the repair is performed in a specific sequence to promote optimal healing and minimize scarring. This procedure is indicated for lacerations that do not exceed half of the vertical height of the lip, distinguishing it from more extensive repairs that may require additional techniques or considerations.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 40652 is indicated for the repair of full-thickness lip lacerations that affect up to half of the vertical height of the lip. This may include injuries resulting from trauma, surgical procedures, or other causes that compromise the structural integrity of the lip. The specific indications for this procedure include:
The procedure for CPT® Code 40652 involves several critical steps to ensure a successful repair of the lip. The steps are as follows:
After the completion of the repair procedure, post-operative care is essential for optimal recovery. Patients are typically advised to follow specific instructions regarding wound care to prevent infection and promote healing. This may include keeping the area clean and dry, avoiding certain foods that could irritate the repair site, and possibly using prescribed topical ointments. Follow-up appointments are important to monitor the healing process and to assess the cosmetic outcome of the repair. Patients should also be informed about signs of complications, such as increased swelling, redness, or discharge, which may require further medical attention.
| Short Descr | RPR LIP FTH | Medium Descr | REPAIR LIP FULL THICKNESS | Long Descr | Repair lip, full thickness; up to half vertical height | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 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). | 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. | 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.) | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GJ | "opt out" physician or practitioner emergency or urgent service | KX | Requirements specified in the medical policy have been met | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| Pre-1990 | Added | Code added. |
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