How To Use CPT Code 13133

CPT code 13133 describes a complex repair procedure on various areas of the body, including the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. This article will provide a comprehensive overview of CPT code 13133, including its description, official definition, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 13133?

CPT code 13133 is used to report a complex repair procedure performed on specific areas of the body, such as the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. This code is used when the repair requires extensive undermining of tissues, scar revision, debridement, and the use of stents or retention sutures in addition to a layered closure. It is important to note that CPT code 13133 should be used in conjunction with CPT code 13132 for the initial complex repair.

2. Official Description

The official description of CPT code 13133 is: ‘Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet 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 procedure on the specified areas of the body, with each additional 5 cm or less requiring a separate reporting.

3. Procedure

When performing a complex repair using CPT code 13133, the healthcare provider follows a detailed procedure:

1. The patient is appropriately prepped and anesthetized for the procedure.
2. The provider assesses the wound and determines the need for a complex repair.
3. If necessary, the provider creates a defect or excises a scar to prepare for the repair.
4. The provider debrides any devitalized tissue or debris from the wound.
5. Jagged edges of a laceration may be trimmed and revised, or an avulsion may be reattached.
6. Extensive undermining of tissue is performed to ensure proper closure.
7. Stents may be placed to maintain anatomical position, and retention sutures may be used to relieve tension on the repaired wound.
8. The provider performs a multilayered closure, which may include subcutaneous sutures and specialized techniques such as a Webster-type subcutaneous suture, a Gilles corner stitch, or a stellate laceration repair.
9. Once the repair is complete, the wound is covered with a bandage.

4. Qualifying circumstances

CPT code 13133 is used for complex repair procedures that involve deeper, jagged, or contaminated wounds. These repairs may require scar revision, extensive undermining of tissues, debridement, and the use of stents or retention sutures. The areas eligible for this code include the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. It is important to note that CPT code 13133 should be used in conjunction with CPT code 13132 for the initial complex repair.

5. When to use CPT code 13133

CPT code 13133 should be used when performing a complex repair procedure on the specified areas of the body, with each additional 5 cm or less requiring a separate reporting. It is important to use this code in conjunction with CPT code 13132 for the initial complex repair. If the wound measures 2.6 cm to 7.5 cm, both codes should be reported together.

6. Documentation requirements

To support a claim for CPT code 13133, the healthcare provider must document the following information:

• The need for a complex repair procedure
• The specific areas of the body involved in the repair
• The length of the wound requiring the additional 5 cm or less reporting
• Details of the procedure performed, including scar revision, debridement, undermining of tissues, and the use of stents or retention sutures
• The start and end time of the procedure
• Any complications or additional procedures performed
• The provider’s signature

7. Billing guidelines

When billing for CPT code 13133, it is important to follow the appropriate guidelines:

• Report CPT code 13133 in addition to the primary procedure code for each additional 5 cm or less requiring a complex repair.
• Do not append modifier 50 to add-on codes when a procedure is performed bilaterally; instead, report the add-on code twice.
• Complex repairs often involve reconstructive procedures and may include the creation of a defect for repair, debridement, and extensive undermining of tissue. These repairs do not include lesion excision, which should be reported separately.
• For simple repairs on the integumentary system, refer to codes 12001 to 12021. For intermediate repairs, refer to codes 12031 to 12057.

8. Historical information

CPT code 13133 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT code 13133

There are several similar codes to CPT code 13133 that are used for different procedures. These codes include:

• CPT code 13132: This code is used for the initial complex repair of wounds on the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet.
• CPT code 12001 to 12021: These codes are used for simple repair procedures on the integumentary system.
• CPT code 12031 to 12057: These codes are used for intermediate repair procedures on the integumentary system.

9. Examples

Here are some examples of cases where CPT code 13133 may be used:

1. A patient presents with a deep laceration on their forehead that requires scar revision, debridement, and extensive undermining of tissue for a complex repair.