2025 CPT code 12020
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Treatment of superficial wound dehiscence; simple closure.
Modifiers may be applicable, depending on the circumstances.For example, modifier 22 (increased procedural services) might be used if the procedure involved significantly more effort than typical, while modifier 59 (distinct procedural service) might be necessary if it was performed in conjunction with another procedure.Always consult the most current CPT guidelines and payer-specific rules for modifier usage.
Medical necessity for code 12020 is established when a patient presents with a superficial wound dehiscence requiring closure to prevent infection, promote healing, and improve cosmetic appearance.Documentation should support the need for the procedure.
The physician's responsibilities include assessing the wound, determining the need for debridement, selecting the appropriate closure technique, performing the procedure, and ensuring proper hemostasis. Post-operative care and follow-up are usually included within the global service, but this is payer-dependent.
In simple words: This code covers fixing a wound that has reopened after it was initially closed. The doctor will clean the wound, remove any dead tissue, and then close it again with stitches or other methods.
This CPT code, 12020, describes the procedure for treating superficial wound dehiscence involving a simple closure.The procedure includes the reopening of the dehisced wound margins, debridement of the wound (removal of dead or infected tissue), irrigation with an antimicrobial agent, and subsequent closure using sutures, staples, or tissue adhesives (e.g., 2-cyanoacrylate), either singularly or in combination.Hemostasis and local/topical anesthesia, if administered, are considered inclusive.
Example 1: A patient presents with a superficial wound dehiscence from a previous abdominal surgery, with minimal tissue loss and no signs of infection. The physician performs a simple wound closure using sutures., A patient presents with a superficial wound dehiscence following a minor surgical procedure on their leg. The wound shows some minor signs of infection. The physician cleans the wound, performs a limited debridement, and then applies adhesive strips to close the wound., A patient who underwent a breast biopsy develops a superficial wound dehiscence 5 days post-operation. The physician removes the existing sutures, cleans the area, performs minor debridement, and performs a simple closure using staples.
** Accurate documentation is crucial for proper reimbursement.Always cross-reference with payer-specific guidelines and policies for precise coding and billing compliance.
- Revenue Code: P6A (Minor Procedures - Skin)
- RVU: Refer to the current Medicare Physician Fee Schedule (MPFS) for relative value units and reimbursement rates.These values are subject to change and vary by geographic location.
- Global Days: The global surgical period is not explicitly defined for this code; it would depend on the complexity of the procedure and the specific payer's guidelines.
- Payment Status: Active
- Modifier TC rule: This code does not typically require a technical component (TC) modifier as it represents the entire service.
- Fee Schedule: Historical fee schedule data is available through various resources such as the CMS website, but these amounts are subject to change yearly. Consult the current fee schedule for accurate information.
- Specialties:General Surgery, Plastic Surgery, Family Medicine
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center, Urgent Care Facility