Summary & Overview
CPT 13101: Complex Repair of Trunk Wound (2.6–7.5 cm)
Headline: CPT 13101: Complex Trunk Wound Repair (2.6–7.5 cm)
Lead: CPT 13101 is the code for complex surgical repair of integumentary wounds on the trunk measuring 2.6 to 7.5 cm. It defines a specific operative service commonly provided in outpatient hospital settings and is relevant to clinicians, coding professionals, and payers nationwide.
What this code represents and why it matters: CPT 13101 captures surgical complexity beyond simple or intermediate repairs, reflecting layered closure, extensive undermining, or scar revision techniques needed for moderate-length trunk wounds. Accurate application of this code affects clinical documentation, billing accuracy, and appropriate payment for resource-intensive procedures.
Key payers covered: This summary addresses coverage and billing considerations relevant to Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Overview of reader takeaways: Readers will find a concise overview of the clinical context for use of CPT 13101, typical sites of service, common coding interactions, and adjacent codes for length increments. The publication provides benchmarks and policy-oriented context to support coding decisions, highlights payer considerations, and outlines related procedural codes for continuity in billing (for example, shorter or additional length codes). The content is intended to clarify when CPT 13101 applies, how it relates to related repair codes, and what documentation elements commonly support its selection.
CPT Code Overview
CPT 13101 denotes complex repair procedures on the integumentary system for a wound located on the trunk with a repair length of 2.6 to 7.5 cm. The procedure falls under the broader service type of surgical repair, integumentary system and typically occurs in an Outpatient Hospital (POS 22) setting. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to the outpatient hospital surgical clinic after sustaining a deep, jagged laceration to the abdominal wall requiring layered closure. The wound measures approximately 4.0 cm after debridement and involves multiple tissue layers with significant loss of dermal and subcutaneous tissue, necessitating complex repair techniques such as extensive undermining, layered closure, and possible scar revision. The clinical workflow includes initial assessment and cleaning, local anesthesia administration, wound measurement and documentation, execution of complex closure with meticulous layered suturing, postoperative instructions, and scheduling of follow-up for wound check and suture removal. The procedure is performed by a surgeon or plastic surgeon and is billed as 13101 for complex repair of a wound to the trunk measuring 2.6 to 7.5 cm.
Coding Specifications
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Modifiers:
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59— Distinct Procedural Service: used when the complex repair represented by13101is separate and distinct from other services performed on the same patient on the same date (for example, a separate laceration repair in a different anatomical region that is not integral to the primary procedure). -
51— Multiple Procedures: applied when13101is one of multiple surgical procedures performed during the same encounter to indicate multiple procedures were performed; sequencing and payer-specific bundling rules apply. -
Provider Taxonomies: