How To Use CPT Code 12053

CPT code 12053 describes the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 5.1 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 12053?

CPT code 12053 is used to describe the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 5.1 to 7.5 cm in size. This code is used when a healthcare professional performs a more complex repair of a larger wound in these specific areas.

2. Official Description

The official description of CPT code 12053 is: ‘Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes 5.1 cm to 7.5 cm.’

3. Procedure

The procedure for CPT code 12053 involves the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes that are 5.1 to 7.5 cm in size. After obtaining informed consent, the patient is brought to the operating room and the operative site is prepped and draped in a sterile manner. Local anesthesia is administered to the area. The wound is then inspected and irrigated with normal saline. Proper debridement of the wound is performed to remove any dead, damaged, or infected tissue. The healthcare professional then proceeds with the repair of the wound by bringing the edges 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 12053 is used for wounds that require an intermediate level of repair on the face, ears, eyelids, nose, lips, and/or mucous membranes. The size of the wound must be between 5.1 and 7.5 cm. This code is appropriate when the healthcare professional performs a more complex repair that involves layered closure of the wound.

5. When to use CPT code 12053

CPT code 12053 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 5.1 and 7.5 cm in size. This code should not be used for smaller or larger wounds, as there are specific codes available for those sizes.

6. Documentation requirements

To support a claim for CPT code 12053, the healthcare professional must document the following information:

• Size and location of the wound
• Details of the repair procedure, including the use of local anesthesia and any debridement performed
• Type of closure used (e.g., sutures, tissue adhesive)
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 12053, ensure that the wound being repaired meets the size criteria of 5.1 to 7.5 cm. The healthcare professional should perform an intermediate level of repair, including layered closure if necessary. It is important to accurately document the details of the procedure to support the use of this code. CPT code 12053 should not be reported with other repair codes for the same wound.

8. Historical information

CPT code 12053 was added to the Current Procedural Terminology system on January 1, 1990. There was a code change on January 1, 2009, which revised the description to specify the inclusion of wounds on the mucous membranes.

9. Examples

1. A patient sustains a 6 cm laceration on their cheek and requires an intermediate repair.
2. A healthcare professional performs an intermediate repair on a 7.2 cm wound on a patient’s nose.
3. A patient presents with a 5.5 cm laceration on their lip, which is repaired using an intermediate technique.
4. A healthcare professional performs an intermediate repair on a 6.8 cm wound on a patient’s ear.
5. A patient requires an intermediate repair for a 7.4 cm laceration on their eyelid.
6. A healthcare professional performs an intermediate repair on a 5.8 cm wound on a patient’s mucous membrane.
7. A patient sustains a 6.5 cm laceration on their nose and requires an intermediate repair.
8. A healthcare professional performs an intermediate repair on a 7.1 cm wound on a patient’s lip.
9. A patient presents with a 5.3 cm laceration on their ear, which is repaired using an intermediate technique.
10. A healthcare professional performs an intermediate repair on a 6.7 cm wound on a patient’s cheek.