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Intermediate repair of wounds located on the neck, hands, feet, and/or external genitalia involves a surgical procedure designed to address injuries that penetrate deeper than the skin's surface. This type of repair is necessary when the wound requires more than simple closure, as it involves the subcutaneous tissue and superficial fascia. The procedure begins with the cleansing of the wound to prevent infection, followed by the administration of a local anesthetic to ensure patient comfort during the repair. The surgeon inspects the wound to assess its depth and extent, determining if it necessitates extensive cleaning or removal of debris, particularly in cases of contamination. A layered closure technique is employed, which may include the use of sutures, staples, or tissue adhesive to secure the wound edges. To reduce tension on the wound and promote optimal healing, the tissues may be undermined using surgical instruments. Control of any bleeding is achieved through chemical means or electrocautery. The closure process involves the careful placement of absorbable sutures in the deepest layers, with the knots being buried to minimize irritation. Alternatively, permanent sutures may be utilized. The final step in the procedure focuses on the superficial layer, where meticulous attention is given to align and evert the wound edges, thereby preventing any depression of the scar as it heals. This procedure is specifically coded as CPT® 12045 for wounds measuring between 12.6 cm and 20.0 cm in length, with other codes available for different wound sizes.
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The intermediate repair of wounds of the neck, hands, feet, and/or external genitalia is indicated for various conditions that necessitate surgical intervention. These include:
The procedure for intermediate repair of wounds involves several critical steps to ensure proper healing and minimize complications. The first step is the thorough cleansing of the wound to eliminate any debris and reduce the risk of infection. Following this, a local anesthetic is administered to numb the area, allowing the patient to remain comfortable throughout the procedure. The surgeon then inspects the wound to assess its depth and extent, determining whether it involves deeper layers of tissue or requires additional cleaning due to contamination.
After the intermediate repair procedure, patients are typically monitored for any immediate complications, such as excessive bleeding or signs of infection. Instructions for post-procedure care are provided, which may include keeping the wound clean and dry, changing dressings as directed, and avoiding activities that could stress the repair site. Patients are advised to watch for signs of infection, such as increased redness, swelling, or discharge from the wound. Follow-up appointments may be scheduled to assess healing and remove any non-absorbable sutures if used. Overall, the expected recovery time will vary based on the individual and the specific characteristics of the wound.
| Short Descr | INTMD RPR N-HF/GENIT12.6-20 | Medium Descr | REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM | Long Descr | Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6A - Minor procedures - skin | MUE | 1 | CCS Clinical Classification | 171 - Suture of skin and subcutaneous tissue |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | F1 | Left hand, second digit | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| Pre-1990 | Added | Code added. |
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