Are you billing all closures as simple repairs? You could be leaving significant revenue on the table. Payers define repairs in three distinct categories: Simple, Intermediate, and Complex. Billing correctly requires documenting why a closure was more than just a simple one-layer suture.

The 3 Tiers of Skin Repair

Simple Repair (CPT 12001-12021):

• One-layer closure of epidermis, dermis, or subcutaneous tissues.
• This is often bundled into other procedures (like excisions or biopsies) and not separately billable.

Intermediate Repair (CPT 12031-12057):

• A layered closure (e.g., repairing dermis/subcutaneous tissue) OR...
• A single-layer closure that is heavily contaminated and requires extensive cleaning.

Complex Repair (CPT 13100-13160):

• Goes beyond layered closure. Requires scar revision, undermining, stents, or retention sutures. This is for the most complicated wounds.

How to Bill Correctly

• Location & Length: Coding is based on location (e.g., scalp, trunk, arms) and the total length of the repair(s) in centimeters.
• Rule of Sums: You must add the lengths of repairs of the same type (e.g., all intermediate) and in the same anatomical group (e.g., trunk).
• Example: A 2cm intermediate repair on the arm and a 3cm intermediate repair on the chest. The arm (12031) and chest (12032) are in different groups, so you bill them on separate lines.
• Example 2: A 2cm and 3cm intermediate repair both on the arm. You sum them to 5cm and bill 12032 (2.6 cm to 7.5 cm).

The Documentation is Key