How To Use CPT Code 12018

CPT code 12018 describes the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 30.0 cm or greater in size. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 12018?

CPT 12018 is used to describe the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 30.0 cm or greater in size. This code is used when the physician closes a wound that involves the epidermis, dermis, or subcutaneous tissue without involvement of deeper structures. It is important to note that in some cases, a single-layer closure may qualify as an intermediate repair if the wound is heavily contaminated and requires extensive cleaning or removal of particulate matter.

2. Official Description

The official description of CPT code 12018 is: ‘Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes over 30.0 cm.’

3. Procedure

The procedure for CPT code 12018 involves the following steps:

1. The physician assesses the superficial wound on the face, ears, eyelids, nose, lips, and/or mucous membranes.
2. If the wound is 30.0 cm or greater in size and involves the epidermis, dermis, or subcutaneous tissue without involvement of deeper structures, the physician proceeds with the repair.
3. The physician cleans the wound thoroughly, removing any debris or particulate matter.
4. If necessary, the physician may administer local anesthesia to numb the area around the wound.
5. The physician then closes the wound using appropriate sutures or adhesive strips.
6. After the closure, the physician may apply a sterile dressing to protect the wound.
7. Instructions for wound care and follow-up may be provided to the patient.

4. Qualifying circumstances

CPT code 12018 is applicable when the physician performs a simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 30.0 cm or greater in size. The repair should involve the epidermis, dermis, or subcutaneous tissue without involvement of deeper structures. It is important to note that the physician may determine if a single-layer closure qualifies as an intermediate repair based on the extent of contamination and the need for extensive cleaning or removal of particulate matter.

5. When to use CPT code 12018

CPT code 12018 should be used when a physician performs a simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 30.0 cm or greater in size. This code is not appropriate for wounds involving deeper structures or for repairs that require more complex techniques.

6. Documentation requirements

To support a claim for CPT code 12018, the physician must document the following information:

• Description of the wound, including its location and size
• Details of the repair procedure, including the technique used (suturing or adhesive strips)
• Any anesthesia administered, if applicable
• Instructions for wound care and follow-up
• Signature of the physician performing the repair

7. Billing guidelines

When billing for CPT code 12018, ensure that the wound meets the criteria of being superficial and 30.0 cm or greater in size. It is important to accurately document the procedure and provide any necessary supporting documentation. CPT code 12018 should not be reported with other codes for repairs involving deeper structures or more complex techniques.

8. Historical information

CPT code 12018 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A physician performs a simple repair of a 35.0 cm laceration on the forehead.
2. A physician closes a 40.0 cm wound on the nose using adhesive strips.
3. A physician sutures a 32.0 cm laceration on the lip.
4. A physician repairs a 50.0 cm wound on the ear using sutures.
5. A physician performs a simple repair of a 38.0 cm laceration on the eyelid.
6. A physician closes a 45.0 cm wound on the mucous membrane of the mouth using sutures.
7. A physician sutures a 33.0 cm laceration on the cheek.
8. A physician repairs a 55.0 cm wound on the external genitalia using adhesive strips.
9. A physician performs a simple repair of a 42.0 cm laceration on the chin.
10. A physician closes a 37.0 cm wound on the earlobe using sutures.