How To Use CPT Code 13160

CPT 13160 refers to the secondary closure of a surgical wound or dehiscence, which is extensive or complicated. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 13160 procedures.

1. What is CPT 13160?

CPT 13160 is a medical procedure code used to describe the secondary closure of a surgical wound or dehiscence that is extensive or complicated. This procedure is typically performed on sites of injury, such as abdominal wounds or contaminated lacerations, to prevent infection and promote the re-epithelialization of new tissue.

2. 13160 CPT code description

The official description of CPT code 13160 is: “Secondary closure of surgical wound or dehiscence, extensive or complicated.”

3. Procedure

The CPT 13160 procedure involves the following steps:

1. Evaluation of the wound to determine the extent of debridement or excision required.
2. Debridement or excision of granulating or dehisced tissue from the wound.
3. Preparation of the wound edges for closure, which may involve undermining or mobilization of surrounding tissue.
4. Complex closure of the wound, which may require the use of sutures, staples, or other methods to secure the wound edges together.
5. Application of antibiotics and a dressing to protect the wound and promote healing.

4. Qualifying circumstances

Patients eligible to receive CPT 13160 services are those with a surgical wound or dehiscence that is extensive or complicated, requiring secondary closure. This may include wounds that were initially left open due to contamination or other concerns, as well as those that have separated or failed to heal properly after a primary closure. The wound must require extensive debridement or be complicated by factors such as size, location, or loss of tissue or skin to cover the wound.

5. When to use CPT code 13160

It is appropriate to bill the 13160 CPT code when a patient requires secondary closure of a surgical wound or dehiscence that is extensive or complicated. This may be due to factors such as contamination, wound separation, or failure to heal after a primary closure. The procedure should involve extensive debridement or excision of tissue, complex closure techniques, and the application of antibiotics and a dressing.

6. Documentation requirements

To support a claim for CPT 13160, the following information should be documented:

• A detailed description of the wound, including its size, location, and any complicating factors.
• The extent of debridement or excision performed on the wound.
• The techniques used for wound closure, including any sutures, staples, or other methods employed.
• The application of antibiotics and a dressing to the wound.
• Any follow-up care or instructions provided to the patient.

7. Billing guidelines

When billing for CPT code 13160, it is important to follow the appropriate guidelines and rules. Do not report CPT 13160 in conjunction with CPT 11960. For packing or simple secondary wound closure, refer to CPT codes 12020 and 12021. Ensure that the documentation supports the claim for CPT 13160, including a detailed description of the wound, the extent of debridement or excision, the closure techniques used, and the application of antibiotics and a dressing.

8. Historical information

CPT 13160 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 13160

Five similar codes to CPT 13160 and how they differ are:

1. CPT 12020: This code is used for treatment of a superficial wound dehiscence with simple closure, which is less extensive and complicated than CPT 13160.
2. CPT 12021: This code is used for treatment of a superficial wound dehiscence with simple closure and packing, which is less extensive and complicated than CPT 13160.
3. CPT 13151: This code is used for complex repair of a wound on the face, ears, eyelids, nose, or lips, which is different from the secondary closure of a surgical wound or dehiscence in CPT 13160.
4. CPT 13152: This code is used for complex repair of a wound on the face, ears, eyelids, nose, or lips, which is different from the secondary closure of a surgical wound or dehiscence in CPT 13160.
5. CPT 11960: This code is used for closure of a skin wound with a local flap, which is different from the secondary closure of a surgical wound or dehiscence in CPT 13160.

10. Examples

Here are 10 detailed examples of CPT code 13160 procedures:

1. A patient with a large abdominal wound that was initially left open due to contamination, requiring extensive debridement and complex closure.
2. A patient with a complicated surgical wound on the lower extremity that has separated and requires secondary closure with extensive debridement and undermining of surrounding tissue.
3. A patient with a contaminated laceration on the back that requires secondary closure after initial wound care and debridement.
4. A patient with a surgical wound on the chest that has failed to heal properly after primary closure, requiring extensive debridement and complex closure techniques.
5. A patient with a large, complicated wound on the upper extremity that requires secondary closure with extensive debridement and mobilization of surrounding tissue.
6. A patient with a surgical wound on the neck that has separated and requires secondary closure with extensive debridement and complex closure techniques.
7. A patient with a contaminated laceration on the scalp that requires secondary closure after initial wound care and debridement.
8. A patient with a surgical wound on the buttock that has failed to heal properly after primary closure, requiring extensive debridement and complex closure techniques.
9. A patient with a large, complicated wound on the thigh that requires secondary closure with extensive debridement and undermining of surrounding tissue.
10. A patient with a surgical wound on the forearm that has separated and requires secondary closure with extensive debridement and mobilization of surrounding tissue.