Summary & Overview
CPT 12002: Simple Repair of Superficial Wounds 2.6–7.5 cm
CPT code 12002 designates the simple repair of superficial wounds measuring 2.6 to 7.5 cm on anatomical sites including the scalp, neck, axillae, external genitalia, trunk, and extremities (including hands and feet). This code is widely used across urgent care, emergency medicine, family medicine, and surgical settings for straightforward laceration management that does not require complex layered closure. Nationally, correct use of this CPT code affects clinical documentation, coding consistency, and payer adjudication for a common procedural category in ambulatory and emergency care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report outlines common clinical scenarios, coding boundaries relative to wound size and complexity, and the primary settings where the service is delivered. Readers will find benchmarks for utilization and common payer considerations, a concise overview of allowable ICD-10 principal diagnoses for typical encounters, and context for related simple repair codes for adjacent wound-size ranges. The summary supports billing staff, clinicians, and compliance teams seeking clear, national-level guidance on the clinical intent and administrative use of CPT code 12002 without providing prescriptive clinical or billing advice.
Billing Code Overview
CPT code 12002 describes the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) for wounds measuring 2.6 to 7.5 cm.
Service Type: Simple wound repair (superficial)
Typical Site of Service: Ambulatory clinic, urgent care, emergency department, or outpatient surgical suite, depending on clinical setting and patient presentation.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after sustaining a 4.0 cm superficial linear laceration to the left forearm when he tripped and struck a fence. The wound involves only the epidermis and superficial dermis without tendon, nerve, or major vessel involvement, and there is no foreign body. After triage and wound assessment, local anesthesia with 1% lidocaine is administered, the wound is irrigated and debrided, and a simple layered closure is performed using nonabsorbable interrupted sutures for the epidermis. The procedure is documented as a simple repair of a superficial wound measuring 4.0 cm, coded with 12002. Typical workflow includes consent, wound cleansing, anesthesia, suture repair, dressing application, post-procedure instructions, and scheduling of a follow-up visit for suture removal.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of a procedure | Use when a distinct E/M visit is performed in addition to the wound repair (e.g., complex evaluation before suturing) |