How To Use CPT Code 12036

CPT code 12036 describes the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 20.1 to 30 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 12036?

CPT code 12036 is used to describe the intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 20.1 to 30 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 12036 is: ‘Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 20.1 cm to 30.0 cm.’

3. Procedure

The procedure for CPT code 12036 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 12036 is appropriate for patients with wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that are 20.1 to 30 cm in size. The healthcare professional must perform a layered closure of the wound, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion. The use of Dermabond may also be considered a qualifying circumstance for this code.

5. When to use CPT code 12036

CPT code 12036 should be used when a healthcare professional performs an intermediate repair of a wound to the scalp, axillae, trunk, and/or extremities (excluding hands and feet) that is 20.1 to 30 cm in size. This code should not be used for wounds outside of this size range or for wounds on the hands or feet.

6. Documentation requirements

To support a claim for CPT code 12036, the healthcare professional must document the following information:

• The size and location of the wound
• The need for intermediate repair
• The use of layered closure
• The type of sutures used
• The application of Dermabond, if applicable
• The date and time of the procedure
• The signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 12036, ensure that the wound meets the size criteria of 20.1 to 30 cm. The healthcare professional should perform a layered closure and document the use of absorbable sutures and Dermabond, if applicable. It is important to follow the guidelines for reporting multiple lacerations and to use the appropriate modifier, such as modifier 51, when reporting multiple procedures.

8. Historical information

CPT code 12036 was added to the Current Procedural Terminology system on January 1, 1990. There was a code change on January 1, 2009, which replaced the previous code for layer closure of wounds in the same size range.

9. Similar codes to CPT 12036

Five similar codes to CPT 12036 include:

• CPT 12031: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 2.6 cm to 7.5 cm
• CPT 12032: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 7.6 cm to 12.5 cm
• CPT 12034: Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet) 12.6 cm to 20.0 cm
• CPT 12035: 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 patient presents with a 25 cm laceration on their trunk. The healthcare professional performs an intermediate repair, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion. Dermabond is applied to the wound for additional support.
2. A patient sustains a 22 cm laceration on their scalp. The healthcare professional performs an intermediate repair, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion. No Dermabond is used in this case.
3. A patient has a 28 cm laceration on their extremity. The healthcare professional performs an intermediate repair, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion. Dermabond is applied to the wound for additional support.
4. A patient presents with a 19 cm laceration on their axilla. The healthcare professional performs an intermediate repair, suturing the inner layer of skin with absorbable sutures and the external layer in a linear fashion. No Dermabond is used in this case.