How To Use CPT Code 12034

CPT code 12034 describes the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 7.6 to 12.5 cm 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 12034?

CPT code 12034 is used to describe the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 7.6 to 12.5 cm in size. This code is used when a healthcare professional performs a layered closure of the wound, suturing the inner layer of skin (subcutaneous, dermis, and/or superficial fascia) with absorbable sutures, followed by suturing the external layer in a linear fashion. Dermabond may also be applied to the wound for additional support.

2. Official Description

The official description of CPT code 12034 is: ‘Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 7.6 cm to 12.5 cm.’

3. Procedure

The procedure for CPT code 12034 involves the following steps:

1. The patient is brought to the operating room and prepared and draped in a sterile manner.
2. Local anesthesia is administered to the operative site.
3. The wound is inspected and irrigated with normal saline.
4. The healthcare professional performs proper debridement of the wound.
5. The wound edges are brought together to form a linear closure.
6. The inner layer of skin (subcutaneous, dermis, and/or superficial fascia) is sutured with absorbable sutures.
7. The external layer is sutured in a linear fashion.
8. Dermabond may be applied to the wound for additional support.

4. Qualifying circumstances

CPT code 12034 is appropriate for wounds that require intermediate repair and meet the following criteria:

• The wounds are located on the scalp, axillae, trunk, and/or extremities (excluding hands and feet).
• The size of the wounds is between 7.6 cm and 12.5 cm.
• The healthcare professional performs a layered closure, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion.

5. When to use CPT code 12034

CPT code 12034 should be used when a healthcare professional performs an intermediate repair of wounds that meet the specified criteria. It is important to accurately measure the size of the wound to determine if it falls within the 7.6 cm to 12.5 cm range. If the wound is smaller or larger than this range, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT code 12034, the healthcare professional must document the following information:

• The location of the wound (scalp, axillae, trunk, and/or extremities).
• The size of the wound (7.6 cm to 12.5 cm).
• A description of the repair procedure, including the layered closure and use of absorbable sutures.
• The use of Dermabond, if applicable.

7. Billing guidelines

When billing for CPT code 12034, ensure that the wound meets the specified criteria and that the healthcare professional performs an intermediate repair. It is important to accurately measure the size of the wound and document the details of the repair procedure. Modifier 51 should be used when reporting multiple repairs in different classifications or groupings. Pay attention to CPT body groupings to ensure accurate coding.

8. Historical information

CPT code 12034 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2009, the code description was changed to specify the layer closure of wounds.

9. Similar codes to CPT 12034

Five similar codes to CPT 12034 include:

• CPT 12031: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 2.5 cm or less
• CPT 12032: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 2.6 cm to 7.5 cm
• CPT 12035: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 12.6 cm to 20.0 cm
• CPT 12036: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 20.1 cm to 30.0 cm
• CPT 12037: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) over 30.0 cm

9. Examples

1. A healthcare professional performs an intermediate repair of a 10 cm wound on the scalp.
2. A patient presents with a 9 cm wound on the trunk, and the healthcare professional performs an intermediate repair.
3. A healthcare professional performs an intermediate repair of an 8 cm wound on the extremity.
4. A patient has a 12 cm wound on the axilla, and the healthcare professional performs an intermediate repair.
5. A healthcare professional performs an intermediate repair of an 11 cm wound on the trunk.
6. A patient presents with a 7.5 cm wound on the extremity, and the healthcare professional performs an intermediate repair.
7. A healthcare professional performs an intermediate repair of a 10 cm wound on the scalp.
8. A patient has a 9 cm wound on the axilla, and the healthcare professional performs an intermediate repair.
9. A healthcare professional performs an intermediate repair of an 8 cm wound on the trunk.