How To Use CPT Code 12042

CPT code 12042 describes the intermediate repair of superficial wounds to the neck, hands, feet, and/or external genitalia that are 2.6 to 7.5 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 12042?

CPT code 12042 is used to describe the intermediate repair of superficial wounds to the neck, hands, feet, and/or external genitalia that are between 2.6 and 7.5 cm in size. This code is used when a healthcare professional performs a multilayered closure or repair of a single skin layer that is heavily contaminated.

2. Official Description

The official description of CPT code 12042 is: ‘Repair, intermediate, wounds of neck, hands, feet and/or external genitalia 2.6 cm to 7.5 cm.’

3. Procedure

The procedure for CPT code 12042 involves the following steps:

1. The patient is brought to the operating room and informed consent is obtained.
2. The operative site is prepped and draped in a sterile manner.
3. Local anesthesia is administered to the patient.
4. The wound is inspected and irrigated with normal saline.
5. Proper debridement of the wound is performed.
6. If the wound is heavily contaminated, extensive cleaning is done to remove particulate matter.
7. The wound edges are brought together to form a linear closure.
8. The inner layer of skin (subcutaneous, dermis, and/or superficial fascia) is sutured with absorbable suture.
9. The external layer is sutured in a linear fashion.
10. Dermabond may be applied to the wound.

4. Qualifying circumstances

CPT code 12042 is used for the intermediate repair of wounds that are 2.6 to 7.5 cm in size and located on the neck, hands, feet, and/or external genitalia. The procedure is performed when the wound is heavily contaminated and requires a multilayered closure or repair of a single skin layer.

5. When to use CPT code 12042

CPT code 12042 should be used when a healthcare professional performs an intermediate repair of a superficial wound on the neck, hands, feet, or external genitalia that is between 2.6 and 7.5 cm in size. This code should not be used for wounds outside of this size range or on other anatomical areas.

6. Documentation requirements

To support a claim for CPT code 12042, the healthcare professional must document the following information:

• The size and location of the wound
• The need for an intermediate repair due to contamination or complexity
• The specific layers involved in the repair
• The type of sutures used
• Any additional procedures performed, such as debridement
• The date and time of the procedure
• The signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 12042, ensure that the procedure meets the criteria for an intermediate repair of a superficial wound on the neck, hands, feet, or external genitalia that is between 2.6 and 7.5 cm in size. It is important to accurately document the details of the procedure to support the claim. Modifier 51 should be used when reporting multiple repairs in different classifications or groupings.

8. Historical information

CPT code 12042 was added to the Current Procedural Terminology system on January 1, 1990. There was a code change on January 1, 2009, which updated the description to include the term “layer closure” for wounds of the neck, hands, feet, and/or external genitalia.

9. Similar codes to CPT code 12042

Five similar codes to CPT code 12042 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 12041: Repair, intermediate, wounds of face, ears, eyelids, nose, lips, and/or mucous membranes 2.6 cm to 7.5 cm
• CPT 12051: Repair, intermediate, wounds of scalp, axillae, trunk, and/or extremities (excluding hands and feet) 20.1 cm to 30.0 cm
• CPT 12057: 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 4 cm wound on their hand that requires an intermediate repair.
2. A healthcare professional performs an intermediate repair on a 6 cm wound on a patient’s neck.
3. A patient has a 3 cm wound on their external genitalia that is repaired using an intermediate technique.
4. A healthcare professional performs an intermediate repair on a 5 cm wound on a patient’s foot.
5. A patient presents with a 7 cm wound on their hand that requires an intermediate repair.
6. A healthcare professional performs an intermediate repair on a 2.5 cm wound on a patient’s neck.
7. A patient has a 6 cm wound on their external genitalia that is repaired using an intermediate technique.
8. A healthcare professional performs an intermediate repair on a 4 cm wound on a patient’s foot.
9. A patient presents with a 3.5 cm wound on their hand that requires an intermediate repair.
10. A healthcare professional performs an intermediate repair on a 7.5 cm wound on a patient’s neck.