How To Use CPT Code 13153
CPT code 13153 describes the repair of complex wounds or lacerations on the eyelids, nose, ears, and/or lips, each additional 5 cm or less. 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 13153?
CPT 13153 is used to describe the repair of complex wounds or lacerations on the eyelids, nose, ears, and/or lips, each additional 5 cm or less. This code is used when the provider performs an additional 5 cm or less complex repair after a separately reportable 7.5 cm repair. The procedure involves 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 13153 is: ‘Repair, complex, eyelids, nose, ears and/or lips each additional 5 cm or less (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 13152.
3. Procedure
The procedure for CPT code 13153 involves the repair of complex wounds or lacerations on the eyelids, nose, ears, and/or lips, each additional 5 cm or less. The provider performs this repair after a separately reportable 7.5 cm repair. The procedure may include elements such as extensive undermining, stents, or retained sutures. Preparation for this procedure may involve the creation of a defect for repairs, such as the excision of a scar requiring a complex repair or the debridement of complicated lacerations or avulsions.
4. Qualifying circumstances
CPT 13153 is used for patients who require the repair of complex wounds or lacerations on the eyelids, nose, ears, and/or lips. The procedure is performed after a separately reportable 7.5 cm repair. The complexity of the repair involves more than a layered closure and may include elements such as extensive undermining, stents, or retained sutures.
5. When to use CPT code 13153
CPT code 13153 should be used when the provider performs an additional 5 cm or less complex repair on the eyelids, nose, ears, and/or lips after a separately reportable 7.5 cm repair. This code should be used in conjunction with CPT code 13152.
6. Documentation requirements
To support a claim for CPT 13153, the provider must document the following information:
- Details of the primary procedure performed (CPT code 13152)
- Specific details of the additional 5 cm or less complex repair
- Date and time of the procedure
- Extent of the wound or laceration repaired
- Elements of the procedure, such as extensive undermining, stents, or retained sutures
- Signature of the provider performing the procedure
7. Billing guidelines
When billing for CPT 13153, ensure that the procedure meets the qualifying circumstances and is performed after a separately reportable 7.5 cm repair. This code should be reported in conjunction with CPT code 13152. Do not append modifier 50 to add-on codes when a procedure is performed bilaterally; instead, report the add-on code twice.
8. Historical information
CPT 13153 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
- A patient undergoes a 7.5 cm complex repair of a laceration on their eyelid. The provider then performs an additional 3 cm complex repair on the same eyelid.
- A patient requires a 7.5 cm complex repair of a laceration on their lip. The provider also performs an additional 4 cm complex repair on the same lip.
- A patient undergoes a 7.5 cm complex repair of a laceration on their nose. The provider then performs an additional 2 cm complex repair on the same nose.
- A patient requires a 7.5 cm complex repair of a laceration on their ear. The provider also performs an additional 5 cm complex repair on the same ear.
- A patient undergoes a 7.5 cm complex repair of a laceration on their eyelid. The provider then performs an additional 1 cm complex repair on the same eyelid.
- A patient requires a 7.5 cm complex repair of a laceration on their lip. The provider also performs an additional 2 cm complex repair on the same lip.
- A patient undergoes a 7.5 cm complex repair of a laceration on their nose. The provider then performs an additional 3 cm complex repair on the same nose.
- A patient requires a 7.5 cm complex repair of a laceration on their ear. The provider also performs an additional 4 cm complex repair on the same ear.
