2025 CPT code 13122
Effective Date: N/A Surgery - Integumentary System Feed
Complex repair of scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)
Modifier 59 may be applicable when used with other repair codes during the same encounter to indicate a distinct procedural service.
Medical necessity for complex repair is established when the wound's characteristics (depth, contamination, involvement of deeper structures) require a more extensive closure than a simple or intermediate repair. Documentation must support the complexity of the repair.
The physician performs a complex, multilayered closure of a wound on the scalp, arms, and/or legs. This involves extensive undermining, possible use of stents, or retained sutures.Preparation includes creating a defect for repair or debriding complicated lacerations or avulsions.
In simple words: This code is used for complex wound repairs on the scalp, arms, or legs. It covers the repair of each additional 5 centimeters or less of the wound beyond the initial repair.It is not used by itself, but along with the code for the main repair.
This code describes a complex repair of wounds on the scalp, arms, or legs for each additional 5 cm or less, listed separately in addition to the primary procedure code. Complex repair involves layered closure of one or more deeper layers of subcutaneous tissue and superficial fascia, along with potentially extensive undermining, exposure of underlying structures, debridement, or involvement of specialized margins. This code is an add-on code and must be used in conjunction with the primary procedure code.
Example 1: A patient presents with a 12 cm complex laceration on the scalp following a bicycle accident.Code 13121 would be reported for the first 5 cm, and code 13122 would be reported twice for the remaining 7 cm (two segments of 5 cm or less)., A patient has a 7 cm complex laceration on the forearm requiring extensive debridement and layered closure. Code 13121 is reported for the first 5cm, and 13122 is reported once for the additional 2 cm., A patient has multiple lacerations: a 4 cm complex laceration on the scalp and a 3 cm complex laceration on the arm. Code 13121 is reported for the 4 cm laceration, and 13121 is reported again for the 3 cm laceration as they are on different anatomical sites.
Documentation should include the location, size (length in centimeters), and complexity (simple, intermediate, or complex) of each wound repair. Details of any debridement, undermining, or involvement of deeper structures must also be documented.If multiple wounds are repaired, documentation must clearly differentiate each wound's location and characteristics.
- Revenue Code: P6B
- Specialties:Plastic Surgery, General Surgery, Emergency Medicine, Dermatology
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center, Emergency Room - Hospital, Other Place of Service