2025 CPT code 12031
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Integumentary System Feed
Intermediate repair of wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less.
Modifiers may be applicable. Modifier 59 may be used to indicate a distinct procedural service. For example, if a complex repair and an intermediate repair are performed during the same encounter, modifier 59 would be appended to the less complex procedure code (intermediate repair).
Medical necessity for intermediate wound repair is established when the wound's characteristics (depth, contamination, location) require more than simple skin closure.The documentation must support the need for layered closure or extensive cleaning.
In simple words: This code represents the repair of a moderately complex wound on the scalp, armpit, torso, arms, or legs (but not hands or feet) that is up to 2.5 centimeters long.The repair involves stitching together multiple layers of tissue beneath the skin.
Intermediate repair includes the repair of wounds that require layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the skin (epidermal and dermal) closure. It includes limited undermining (defined as a distance less than the maximum width of the defect, measured perpendicular to the closure line, along at least one entire edge of the defect). Single-layer closure of heavily contaminated wounds that have required extensive cleaning or removal of particulate matter also constitutes intermediate repair.
Example 1: A patient presents with a 2 cm laceration on their right forearm following a fall. The wound is cleaned and closed with a layered suture technique involving the subcutaneous tissue and fascia, along with skin closure., A patient has a 1.5 cm laceration on their scalp from a dog bite.The wound is heavily contaminated and requires extensive cleaning before being closed in a single layer., A patient sustains a 2.5 cm laceration on their back during a car accident. The wound is cleaned and repaired using layered closure, including the subcutaneous tissue and fascia.
Documentation should include the location, size (in centimeters), and depth of the wound, the method of closure (layered or single-layer), and any debridement or cleaning performed. If significant contamination is present, the extent of cleaning should be clearly documented.
** For extensive debridement not associated with open fractures or dislocations, see codes 11042-11047. For debridement associated with open fractures or dislocations, see 11010-11012.
- Specialties:General Surgery, Plastic Surgery, Emergency Medicine, Family Medicine
- Place of Service:Office, Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Emergency Room - Hospital, Ambulatory Surgical Center,Other Place of Service