How To Use CPT Code 13131

CPT 13131 refers to a complex repair procedure for wounds measuring 1.1 cm to 2.5 cm in specific body areas, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 13131?

CPT 13131 is a medical code used to describe a complex repair procedure for wounds measuring 1.1 cm to 2.5 cm in size, located on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. This code is used by medical professionals to accurately document and bill for this specific type of wound repair.

2. 13131 CPT code description

The official description of CPT code 13131 is: “Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider performs a complex repair or multilayered closure of a wound measuring 1.1 cm to 2.5 cm in size on the specified body areas.
3. This procedure involves more than a layered closure, and may require scar revision, debridement of devitalized tissue and debris, trimming and revising jagged edges of a laceration or reattaching an avulsion, and extensive undermining of tissue.
4. The provider may need to place stents to keep structures in proper anatomic position or retention sutures to relieve tension on the repaired wound.
5. Elements of this procedure can include a Webster-type subcutaneous suture, a Gilles corner stitch, and/or a stellate laceration repair.
6. Once the provider has cleaned and revised or repaired the deep structures of the wound, they close the wound in layers and cover it with a bandage.

4. Qualifying circumstances

Patients eligible to receive CPT code 13131 services are those with wounds measuring 1.1 cm to 2.5 cm in size, located on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. These wounds must require complex repair, which involves more than a simple layered closure and may necessitate additional procedures such as scar revision, debridement, extensive undermining of tissues, and placement of stents or retention sutures.

5. When to use CPT code 13131

It is appropriate to bill the 13131 CPT code when a medical professional performs a complex repair procedure on a wound measuring 1.1 cm to 2.5 cm in size, located on the specified body areas. This code should be used when the repair involves more than a simple layered closure and requires additional procedures such as scar revision, debridement, extensive undermining of tissues, and placement of stents or retention sutures.

6. Documentation requirements

To support a claim for CPT 13131, the following information should be documented:

• Location and size of the wound(s)
• Description of the complex repair procedure performed, including any additional procedures such as scar revision, debridement, extensive undermining of tissues, and placement of stents or retention sutures
• Pre- and post-operative diagnosis
• Medical necessity for the complex repair
• Any complications or additional treatments required

7. Billing guidelines

When billing for CPT code 13131, it is important to follow the appropriate guidelines and rules. Ensure that the wound size and location match the code description, and that the repair procedure performed is indeed complex, involving more than a simple layered closure. Additionally, be aware of similar codes for different wound sizes and locations, and use the correct code based on the specific circumstances of the case.

8. Historical information

CPT 13131 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 13131

Five similar codes to CPT 13131 and how they differentiate are:

1. CPT 13132: This code is used for complex repair of wounds measuring 2.6 cm to 7.5 cm in the same body areas as CPT 13131.
2. CPT 13133: This code is used for each additional 5 cm or less in addition to CPT 13132 if the wounds measure more than 7.5 cm in the same body areas as CPT 13131.
3. CPT 12001 to 12021: These codes are used for simple repair procedures on the integumentary system, involving single-layer closure of superficial wounds.
4. CPT 12031 to 12057: These codes are used for intermediate repair procedures on the integumentary system, involving layered closure or deeper subcutaneous tissue and superficial fascia.

10. Examples

Here are 10 detailed examples of CPT code 13131 procedures:

1. A patient with a 2 cm laceration on the chin requiring complex repair, including scar revision and extensive undermining of tissues.
2. A patient with a 1.5 cm wound on the cheek resulting from an animal bite, requiring complex repair with debridement and placement of retention sutures.
3. A patient with a 2.3 cm avulsion injury on the hand, requiring complex repair with reattachment and stent placement.
4. A patient with a 1.2 cm stellate laceration on the forehead, requiring complex repair with a Gilles corner stitch and Webster-type subcutaneous suture.
5. A patient with a 2.5 cm wound on the neck, requiring complex repair with extensive undermining of tissues and layered closure.
6. A patient with a 1.8 cm laceration on the axilla, requiring complex repair with debridement and placement of retention sutures.
7. A patient with a 2.1 cm wound on the genitalia, requiring complex repair with stent placement and extensive undermining of tissues.
8. A patient with a 1.1 cm wound on the foot, requiring complex repair with scar revision and layered closure.
9. A patient with a 2.4 cm laceration on the mouth, requiring complex repair with a Gilles corner stitch and Webster-type subcutaneous suture.
10. A patient with a 1.9 cm wound on the cheek, requiring complex repair with debridement, extensive undermining of tissues, and stent placement.