Summary & Overview
CPT 12006: Simple Repair of Superficial Wounds, 20.1–30.0 cm
CPT code 12006 is a nationally recognized billing code for the simple repair of superficial wounds ranging from 20.1 cm to 30.0 cm in length, affecting areas such as the scalp, neck, axillae, external genitalia, trunk, and extremities. This code is widely used in clinical settings, particularly offices, to document and bill for surgical procedures on the integumentary system. The code is relevant for a variety of specialties, including dermatology, surgery, family medicine, general practice, and emergency medicine.
Major payers covering this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides an overview of payer coverage, clinical context, and related coding benchmarks. Readers will gain insight into the procedural scope, typical clinical scenarios, and policy updates relevant to the use of CPT 12006. The summary also highlights associated modifiers and related codes, offering a comprehensive understanding of how this code fits within broader wound repair billing practices.
This article is designed for healthcare professionals, billing specialists, and policy analysts seeking clarity on the national landscape for superficial wound repair procedures. It covers essential information for accurate coding, payer expectations, and clinical documentation, ensuring readers are informed about the latest developments and standards for CPT 12006.
CPT Code Overview
CPT 12006 represents a simple repair of superficial wounds measuring 20.1 cm to 30.0 cm on the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet). This procedure is classified under surgical procedures on the integumentary system. The typical site of service for this code is the office (POS 11), where clinicians address lacerations and other superficial injuries requiring straightforward closure techniques.
Clinical & Coding Specifications
Clinical Context
A patient presents to the office with multiple superficial lacerations on the trunk and extremities, such as after a fall or minor accident. The wounds are clean, without foreign bodies, and require simple repair. The total length of all wounds repaired is between 20.1 cm and 30.0 cm. The procedure is performed by a provider in dermatology, surgery, family medicine, general practice, or emergency medicine. The clinical workflow includes assessment, cleaning, and closure of the wounds using simple techniques such as suturing, adhesive strips, or tissue adhesives. Documentation includes the location, length, and method of repair for each wound.
Coding Specifications
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Modifier
51(Multiple Procedures): Used when more than one procedure is performed during the same session. Indicates that12006is one of several procedures. -
Modifier
59(Distinct Procedural Service): Used to indicate that12006is a distinct service from other procedures performed on the same day, such as repairs at different anatomical sites.
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