How To Use CPT Code 13100

CPT code 13100 describes a complex repair of a wound to the trunk that is 1.1 to 2.5 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 13100?

CPT 13100 is a code used to describe a complex repair of a wound to the trunk that is between 1.1 and 2.5 cm in size. This procedure involves more than a simple or intermediate repair, and may include elements such as extensive undermining, stents, or retained sutures. It is typically performed by a physician and is considered a reconstructive procedure.

2. Official Description

The official description of CPT code 13100 is: ‘Repair, complex, trunk 1.1 cm to 2.5 cm.’ This code is used for a multilayered closure of a wound to the trunk that requires more than layered closure, such as extensive undermining or the use of specialized techniques like Webster-type subcutaneous sutures or Gilles corner stitches. It does not include lesion excision, which is reported separately.

3. Procedure

The procedure for CPT code 13100 involves a complex repair or multilayered closure of a wound to the trunk that is 1.1 to 2.5 cm in size. This may include elements such as extensive undermining, stents, or retained sutures. The physician prepares for the procedure by creating a defect for repairs, such as excision of a scar requiring a complex repair, or by debriding complicated lacerations or avulsions. The specific techniques used may vary depending on the nature of the wound and the physician’s preferred approach.

4. Qualifying circumstances

CPT 13100 is used for wounds on the trunk that require a complex repair. This may include wounds resulting from trauma, surgical procedures, or other causes. The size of the wound must be between 1.1 and 2.5 cm. The procedure is typically performed by a physician and may involve elements such as extensive undermining, stents, or retained sutures. It is important to note that CPT 13100 does not include lesion excision, which should be reported separately.

5. When to use CPT code 13100

CPT code 13100 should be used when a physician performs a complex repair of a wound to the trunk that is between 1.1 and 2.5 cm in size. This code is appropriate when the procedure involves more than a simple or intermediate repair, and includes elements such as extensive undermining, stents, or retained sutures. It is important to accurately document the size of the wound and the specific techniques used during the procedure to support the use of CPT code 13100.

6. Documentation requirements

To support a claim for CPT 13100, the physician must document the following information:

• Size and location of the wound
• Details of the complex repair performed, including any specialized techniques used
• Extent of undermining, if applicable
• Use of stents or retained sutures, if applicable
• Any other relevant details about the procedure
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 13100, ensure that the procedure meets the criteria for a complex repair of a wound to the trunk that is 1.1 to 2.5 cm in size. It is important to accurately document the details of the procedure to support the use of this code. CPT 13100 should not be reported if the wound is 1.0 cm or less, as there are separate codes for simple or intermediate repairs. Additionally, lesion excision should be reported separately and not included in the complex repair code.

8. Historical information

CPT 13100 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A physician performs a complex repair of a 2 cm laceration on the trunk of a patient.
2. A patient undergoes a multilayered closure of a 1.5 cm wound on their abdomen, which requires extensive undermining.
3. A physician performs a complex repair of a 2.3 cm wound on the back, using specialized techniques like Webster-type subcutaneous sutures.
4. A patient undergoes a complex repair of a 1.8 cm wound on their chest, which involves the use of retained sutures.
5. A physician performs a multilayered closure of a 2.2 cm wound on the abdomen, which requires stents to support the repair.
6. A patient undergoes a complex repair of a 1.4 cm wound on their back, which involves extensive undermining and the use of Gilles corner stitches.
7. A physician performs a complex repair of a 2.5 cm wound on the trunk, which requires both extensive undermining and the use of retained sutures.
8. A patient undergoes a multilayered closure of a 1.7 cm wound on their abdomen, which involves the use of specialized techniques like Webster-type subcutaneous sutures.
9. A physician performs a complex repair of a 2.1 cm wound on the back, which requires both extensive undermining and the use of stellate laceration repair techniques.