2025 CPT code 13153
(Active) Effective Date: N/A Surgery - Integumentary System Surgery Feed
Complex repair of eyelids, nose, ears, and/or lips; each additional 5 cm or less (List separately in addition to code for primary procedure).
Modifiers may be applicable in certain situations (e.g., 59 for a distinct procedural service).Modifier 59 may be appended to indicate the distinct and separate complex repair within the same anatomical grouping, which is not contiguous to the initial repair.
Medical necessity for this procedure must be supported by documentation indicating the complexity of the wound and the need for this specific type of repair.
The physician performs the additional complex repair of the eyelids, nose, ears, and/or lips following the primary complex repair (13152).This involves precise surgical techniques and knowledge of facial anatomy.
In simple words: This code is used for complex repairs of cuts or tears on the eyelids, nose, ears, or lips that are 5 centimeters long or less, in addition to a larger repair. It involves more complicated techniques like deep stitching, supports, or stitches that stay in place longer.It’s used along with another code (13152) that covers the main repair.
This code describes a complex repair of wounds to the eyelids, nose, ears, and/or lips for each additional 5 cm or less.It is used in addition to the primary procedure code (13152) and involves more than a layered closure, such as extensive undermining, stents, or retained sutures.It includes the creation of a limited defect for repairs or the debridement of complicated lacerations or avulsions.
Example 1: A patient presents with a 7.6 cm complex laceration to the eyelid following a dog bite.13152 is reported for the first 7.5 cm and 13153 is reported for the additional 0.1 cm., A patient undergoes excision of a 4 cm scar on the nose requiring complex repair.The defect is then repaired, and 13152 would be reported for the initial 5 cm if the total repair exceeds 5cm. If the defect created by the excision and repair exceeds 5cm and up to 7.5cm then 13152 is reported.If the repair extended over 7.5cm then 13152 and 13153 would be reported. If the repair was 5 cm or less, then only 13152 would be reported., A patient has a complex 6.5 cm laceration on the ear following a car accident. 13152 is reported. If the laceration measured 7.6cm. then 13152 and 13153 would be reported.
Documentation should include the location, size (in centimeters), and complexity of each repair, including the specific techniques used (e.g., undermining, stents, retention sutures).The cause of the wound should also be documented.Photographs may be beneficial.
** This code is for complex repairs, not simple or intermediate repairs.It is important to accurately measure and document the length of each repair. Do not append modifier 50 to add-on codes when a procedure is performed bilaterally; instead, you should report the add-on code twice.
- Specialties:Plastic Surgery, Facial Plastic Surgery, Dermatology, Emergency Medicine, General Surgery,Otolaryngology
- Place of Service:Physician's Office, Outpatient Hospital, Ambulatory Surgical Center, Emergency Room - Hospital, Inpatient Hospital