How To Use CPT Code 13102

CPT code 13102 describes a complex repair of each additional 5 cm or less of a wound to the trunk. This code is listed separately in addition to the code for the primary procedure and covers additional wounds. 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 13102?

CPT code 13102 is used to describe a complex repair of each additional 5 cm or less of a wound to the trunk. This code is an add-on code and should always be reported with the primary procedure code, 13101, only when the size of the repaired region on the trunk exceeds 7.5 cm. It is important to note that CPT code 13102 is listed separately in addition to the code for the primary procedure and covers additional wounds.

2. Official Description

The official description of CPT code 13102 is: ‘Repair, complex, trunk each additional 5 cm or less (List separately in addition to code for primary procedure).’ This code should be used when performing a complex repair of each additional 5 cm or less of a wound to the trunk.

3. Procedure

The procedure for CPT code 13102 involves a complex repair or multilayered closure of a wound to the trunk. This procedure goes beyond a simple layered closure and may include elements such as extensive undermining, stents, or retained sutures. The physician prepares for this procedure by creating a defect for repairs, such as excision of a scar requiring a complex repair, or by performing the debridement of complicated lacerations or avulsions.

4. Qualifying circumstances

CPT code 13102 is used for complex repairs of each additional 5 cm or less of a wound to the trunk. Qualifying circumstances for this code include wounds that require more than a layered closure, involving elements such as extensive undermining, stents, or retained sutures. It is important to note that complex repairs do not include lesion excision, which is separately reportable.

5. When to use CPT code 13102

CPT code 13102 should be used when performing a complex repair of each additional 5 cm or less of a wound to the trunk. This code is an add-on code and should only be reported when the size of the repaired region on the trunk exceeds 7.5 cm. It is important to use this code in conjunction with the primary procedure code, 13101, when applicable.

6. Documentation requirements

To support a claim for CPT code 13102, the physician must document the following information:

• Specific details of the complex repair performed
• Size of the repaired region on the trunk
• Any additional wounds covered by this code
• Any other relevant details or complications encountered during the procedure

7. Billing guidelines

When billing for CPT code 13102, it is important to ensure that the primary procedure code, 13101, is also reported. CPT code 13102 should only be reported when the size of the repaired region on the trunk exceeds 7.5 cm. Modifier 59 (Distinct procedural service) should be used to indicate that complex repair of each additional 5 cm or less of the trunk has been distinctly performed. It is important to follow the specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT code 13102 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Examples

1. A physician performs a complex repair of a 10 cm wound to the trunk. The procedure codes to be reported are: 13101, 13102.
2. A surgeon performs a complex repair of a 15 cm wound to the trunk and a 7 cm wound to the scalp. The procedure codes to be reported are: 13101, 13102, 13103.
3. A dermatologist performs a complex repair of a 6 cm wound to the face and a 4 cm wound to the nose. The procedure codes to be reported are: 13101, 13102, 13104.
4. A plastic surgeon performs a complex repair of a 20 cm wound to the trunk. The procedure codes to be reported are: 13101, 13102, 13102-59.
5. A general surgeon performs a complex repair of a 12 cm wound to the trunk and a 5 cm wound to the hand. The procedure codes to be reported are: 13101, 13102, 13120.
6. A plastic surgeon performs a complex repair of a 8 cm wound to the trunk with debridement and retention sutures. The procedure codes to be reported are: 13101, 13102, 13121.
7. A dermatologist performs a complex repair of a 5 cm wound to the face. The procedure codes to be reported are: 13101, 13102.
8. A surgeon performs a complex repair of a 9 cm wound to the trunk and a 6 cm wound to the hand. The procedure codes to be reported are: 13101, 13102, 13120.
9. A plastic surgeon performs a complex repair of a 14 cm wound to the trunk. The procedure codes to be reported are: 13101, 13102, 13102-59.