How To Use CPT Code 13152

CPT code 13152 describes the complex repair of wounds or lacerations on the eyelids, nose, ears, and/or lips that measure between 2.6 cm and 7.5 cm. 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 13152?

CPT 13152 is used to describe the complex repair of wounds or lacerations on the eyelids, nose, ears, and/or lips. This code is specifically used when the total length or wound diameter repaired in a complex manner falls between 2.6 cm and 7.5 cm. Complex repairs involve more than a layered closure and may include elements such as extensive undermining, stents, or retained sutures.

2. Official Description

The official description of CPT code 13152 is: ‘Repair, complex, eyelids, nose, ears, and/or lips 2.6 cm to 7.5 cm.’

3. Procedure

The procedure for CPT code 13152 involves the complex repair or multilayered closure of wounds or lacerations on the eyelids, nose, ears, and/or lips. The total length or wound diameter repaired in a complex manner must be between 2.6 cm and 7.5 cm. This procedure may include elements such as extensive undermining, stents, or retained sutures. It is important to note that preparation for this procedure may involve creating a defect for repairs, such as excision of a scar requiring complex repair or debridement of complicated lacerations or avulsions.

4. Qualifying circumstances

CPT 13152 is used for the repair of wounds or lacerations on the eyelids, nose, ears, and/or lips that require a complex repair. The total length or wound diameter repaired in a complex manner must be between 2.6 cm and 7.5 cm. This procedure involves more than a layered closure and may include elements such as extensive undermining, stents, or retained sutures. It is important to note that lesion excision is not included in this code and should be reported separately.

5. When to use CPT code 13152

CPT code 13152 should be used when a physician performs a complex repair or multilayered closure of wounds or lacerations on the eyelids, nose, ears, and/or lips. The total length or wound diameter repaired in a complex manner must be between 2.6 cm and 7.5 cm. It is important to note that for wound areas measuring 1.0 cm or less, intermediate or simple repair codes should be used instead.

6. Documentation requirements

To support a claim for CPT 13152, the physician must document the following information:

• Description of the wound or laceration being repaired
• Total length or wound diameter repaired in a complex manner
• Details of the complex repair procedure performed, including elements such as extensive undermining, stents, or retained sutures
• Preparation for the procedure, such as excision of a scar requiring complex repair or debridement of complicated lacerations or avulsions
• Any additional relevant information or complications encountered during the procedure
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 13152, ensure that the physician performs a complex repair or multilayered closure of wounds or lacerations on the eyelids, nose, ears, and/or lips. The total length or wound diameter repaired in a complex manner must be between 2.6 cm and 7.5 cm. It is important to note that lesion excision is not included in this code and should be reported separately. There are no specific guidelines regarding reporting CPT 13152 with other codes.

8. Historical information

CPT 13152 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 4 cm laceration on the eyelid.
2. A patient presents with a 6 cm wound on the nose, and the physician performs a complex repair.
3. A complex repair is performed by a physician on a 5 cm laceration on the ear.
4. A patient requires a complex repair of a 3 cm wound on the lip, which is performed by a physician.
5. A physician performs a complex repair of a 7 cm laceration on the eyelid and nose.
6. A patient presents with a 2.5 cm wound on the ear, and the physician performs a complex repair.
7. A complex repair is performed by a physician on a 6 cm laceration on the lip.
8. A patient requires a complex repair of a 4 cm wound on the nose and ear, which is performed by a physician.
9. A physician performs a complex repair of a 3 cm laceration on the eyelid and lip.
10. A patient presents with a 7.5 cm wound on the nose, and the physician performs a complex repair.