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Coding tip: Understand the three categories of repair codes
Ambulatory Surgery Reimbursement Update, June 19, 2007
Repair codes in the 10000 section are divided into three categories: simple, intermediate and complex repairs/closures. These codes are also described by anatomic site and wound size.
In a simple repair, the wound is superficial, and involves partial or full-thickness damage to the skin/subcutaneous tissues. Deeper structures are not involved, and only a simple one-layer suturing is required.
An intermediate repair is used for wounds/lacerations/excisions where more of the deeper layers of subcutaneous tissue and non-muscle fascia are repaired (in addition to skin and subcutaneous tissue). This is a two-layered closure.
A complex repair requires more than a layered closure. Complex repairs include those requiring revision, debridement, extensive undermining, and/or placement of stents or retention sutures. Complex repairs also include wounds that require creation of a defect and special preparation of the site. When conducting these types of repairs, the surgeon should state that a "complex" repair is performed in the operative report documentation.
This tip is brought to you by Ellis Medical Consulting, Inc.
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