- Understand Wound Repair Categories: Simple, intermediate, and complex repairs are coded differently. Be sure to identify the type of repair based on the CPT® guidelines.
- Measure Wounds Correctly: For repair coding, measure the wound at its greatest length. Add lengths of multiple wounds in the same classification and anatomic area.
- Recognize the Difference Between Excision and Destruction: Excision involves cutting, while destruction includes methods like electrosurgery, cryosurgery, and laser.
- Code Lesion Excisions by Size: Include the widest margin required for complete excision. The size of the lesion plus the narrowest margin is used for coding.
- Know When to Use Lesion Destruction Codes: Use destruction codes (17000-17004) for premalignant lesions like actinic keratosis and benign lesions that don’t require histopathological examination.
- Use Specific Codes for Mohs Micrographic Surgery: Recognize the unique coding for Mohs surgery (17311-17315), which is used for skin cancers requiring a high level of precision.
- Distinguish Between Adjacent Tissue Transfers and Skin Grafts: Understand the difference in coding for these procedures, particularly in terms of size and complexity.
- Remember Location-Specific Codes: Some codes are specific to body location, such as grafts or excisions on the scalp, eyelids, nose, ears, and lips.
- Report Each Biopsy Separately: Each separate biopsy should be reported, but be mindful of bundling issues and guidelines.
- Use Modifier -51 for Multiple Procedures: If multiple procedures are performed during the same operative session, apply modifier -51 to secondary procedures.
- Recognize When to Use Flap Reconstruction Codes: Flap reconstructions are coded separately from excisions and have specific criteria based on location and complexity.
- Apply Modifier -59 Correctly: Use this modifier to distinguish procedures that are usually bundled but are separate and distinct under certain circumstances.
- Skin Substitute Grafts Have Their Own Codes: Be familiar with the specific codes for skin substitute grafts, which differ from traditional skin grafts.
- Know the Codes for Benign and Malignant Lesions: Ensure correct coding based on the lesion’s pathology. Benign and malignant lesions have different code sets.
- Understand Debridement Coding: Debridement is coded based on depth (skin, subcutaneous tissue, muscle, bone) and surface area.
- Factor in the Complexity of Laceration Repairs: Coding depends on the wound’s complexity, contamination, location, and whether extensive cleaning or material removal is required.
- Use the Correct Codes for Dermabrasion: Different codes exist for dermabrasion for acne scars versus rhinophyma or other purposes.
- Identify When to Code for Surgical Preparation: Surgical preparation of a wound for grafting or other procedures has its own set of codes.
- Report Pressure Ulcer Stages Accurately: Pressure ulcers are staged based on severity, and coding should reflect the appropriate stage.
- Stay Updated on Coding Changes: CPT® codes can change annually, so it’s important to stay current with the American Medical Association (AMA) and AAPC updates.
These tips are aligned with AAPC’s CPC exam structure and are intended to aid in navigating common questions related to CPT Integumentary System Coding.