2025 CPT code 12035
(Active) Effective Date: N/A Revision Date: N/A Surgery - Intermediate Repair Integumentary System Feed
Intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm.
Modifiers may be appropriate depending on the circumstances.Modifier 51 may be added for multiple procedures (if different procedures are performed).
Medical necessity for wound repair is established by the presence of a wound requiring closure to promote healing and prevent complications such as infection or excessive scarring. The depth and extent of the wound, as well as the patient’s overall health, will influence the medical necessity.
The clinical responsibility for this procedure lies with the physician performing the wound repair. This includes pre-operative assessment, wound preparation (including debridement if necessary), wound closure, and post-operative instructions.
In simple words: This code is for fixing medium-sized wounds (12.6 to 20 centimeters long) on the head, armpits, body, or arms and legs (not including hands and feet).The repair involves stitching up the deeper layers of skin in addition to the surface.
This CPT code encompasses the intermediate repair of wounds located on the scalp, axillae, trunk, and/or extremities (excluding hands and feet), with a total length ranging from 12.6 cm to 20.0 cm.The procedure involves layered closure of one or more deeper layers of subcutaneous tissue and superficial fascia, in addition to the skin closure.It may include limited undermining (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 requiring extensive cleaning also falls under this category.
Example 1: A patient presents with a 15 cm laceration on their thigh following a motor vehicle accident. The wound requires layered closure of the subcutaneous tissue and superficial fascia.Code 12035 is appropriate., A patient sustains a 13 cm laceration to their scalp during a fall. The wound is heavily contaminated and requires extensive cleansing and debridement before layered closure. Code 12035 is appropriate., A patient presents with two separate lacerations on their back, one measuring 8 cm and the other measuring 7 cm. Both require intermediate repair, and the total length is 15 cm. Code 12035 is appropriate.
** Accurate documentation is crucial for appropriate reimbursement.Ensure that the physician's notes clearly describe the wound(s) and the repair performed.Consult payer guidelines for specific coverage and reimbursement policies.
- Revenue Code: P6A (Minor Procedures - Skin)
- RVU: The RVUs for this code vary depending on geographic location and payer. Consult the appropriate fee schedule for the most up-to-date information.
- Global Days: The global period for this procedure is not explicitly defined in the CPT code description.Consult payer guidelines for specific information on the post-operative follow-up period.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Fee Schedule: Historical fee schedules for CPT code 12035 will vary by payer and location. Consult payer-specific fee schedules for historical data.
- Specialties:General Surgery, Plastic Surgery, Emergency Medicine
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center, Urgent Care Facility