How To Use CPT Code 12052

CPT code 12052 describes the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 2.6 to 5.0 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 12052?

CPT code 12052 is used to describe the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 2.6 to 5.0 cm in size. This code is used when a healthcare professional performs a more complex repair of a wound in these specific areas, involving multiple layers of tissue and potentially requiring sutures or other closure techniques.

2. Official Description

The official description of CPT code 12052 is: ‘Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes 2.6 cm to 5.0 cm.’

3. Procedure

The procedure for CPT code 12052 involves the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 2.6 to 5.0 cm in size. The healthcare professional begins by preparing the patient and the operative site in a sterile manner. Local anesthesia is administered to ensure the patient’s comfort during the procedure.

After inspection and irrigation of the wound with normal saline, the healthcare professional performs proper debridement to remove any dead, damaged, or infected tissue. The wound edges are then brought together to form a linear closure. The inner layer of skin, including the subcutaneous tissue, dermis, and/or superficial fascia, is sutured with absorbable sutures. The external layer is sutured in a linear fashion. Dermabond, a tissue adhesive, may be applied to the wound to aid in the healing process.

4. Qualifying circumstances

CPT code 12052 is used for wounds that require intermediate repair on the face, ears, eyelids, nose, lips, and/or mucous membranes. The size of the wound must be between 2.6 and 5.0 cm. This code is appropriate when the healthcare professional performs a more complex repair involving multiple layers of tissue and potentially requiring sutures or other closure techniques.

5. When to use CPT code 12052

CPT code 12052 should be used when a healthcare professional performs an intermediate repair of a wound on the face, ears, eyelids, nose, lips, and/or mucous membranes that is between 2.6 and 5.0 cm in size. This code should not be used for wounds outside of these specific areas or for wounds that are smaller or larger than the specified size range.

6. Documentation requirements

To support a claim for CPT code 12052, the healthcare professional must document the following information:

• The size and location of the wound
• The need for intermediate repair
• The specific layers of tissue involved in the repair
• The closure technique used (e.g., sutures, tissue adhesive)
• The date and time of the procedure
• Any complications or additional procedures performed
• The healthcare professional’s signature

7. Billing guidelines

When billing for CPT code 12052, ensure that the healthcare professional performs an intermediate repair of a wound on the face, ears, eyelids, nose, lips, and/or mucous membranes that is between 2.6 and 5.0 cm in size. This code should not be reported for wounds outside of these specific areas or for wounds that are smaller or larger than the specified size range.

It is important to note that CPT code 12052 should not be reported if a simple repair code (e.g., 12001-12021) or a more complex repair code (e.g., 12057) is more appropriate based on the physician’s chart notes. The choice of the correct code depends on the depth and complexity of the repair, as well as the anatomic site.

8. Historical information

CPT code 12052 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 of the face, ears, eyelids, nose, lips, and/or mucous membranes in the 2.6 to 5.0 cm size range.

9. Similar codes to CPT 12052

Five similar codes to CPT 12052 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 scalp, axillae, trunk, and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm
• CPT 12042: Repair, intermediate, wounds of scalp, axillae, trunk, and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm
• CPT 12051: Repair, intermediate, wounds of face, ears, eyelids, nose, lips, and/or mucous membranes 2.5 cm or less

9. Examples

1. A healthcare professional performs an intermediate repair of a 3.0 cm wound on the eyelid of a patient.
2. A patient presents with a 4.5 cm laceration on their nose, and a healthcare professional performs an intermediate repair.
3. A healthcare professional performs an intermediate repair of a 2.8 cm wound on the lip of a patient.
4. A patient sustains a 5.0 cm laceration on their ear, and a healthcare professional performs an intermediate repair.
5. A healthcare professional performs an intermediate repair of a 3.5 cm wound on the mucous membrane of a patient’s mouth.