Find policies, billing codes, payers, states, and providers
CPT 13131: Complex Wound Repair of Cheek/Chin/Mouth/Neck/Hands
CPT code 13131 denotes a complex repair of wounds measuring 1.1 cm to 2.5 cm on anatomically sensitive areas such as the cheeks, chin, mouth, neck, axillae, genitalia, hands, and feet. It captures procedures that go beyond basic layered closures by including scar revision, debridement, extensive undermining of tissues, and the potential use of stents or retention sutures. This code matters nationally because it differentiates higher-complexity soft-tissue repairs from simpler closures, affecting clinical documentation, coding accuracy, and payment classification across outpatient and inpatient surgical settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 13131 is appropriate, benchmarks and comparative coverage considerations across major national payers, and the typical sites of service where this procedure is performed. The publication also outlines coding nuances that influence claims adjudication and common modifier usage (listed separately), helping billing professionals and policy analysts understand how this code fits into broader surgical repair coding frameworks. Data not available in the input is indicated where relevant.
Customize your policy alerts
Sign up for cpt 13131 policy alerts
Get alerted when payer policies referencing 13131 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 13131 describes repair of a wound measuring 1.1 cm to 2.5 cm located on the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet. The procedure may include scar revision, debridement, extensive undermining of tissues, and use of stents or retention sutures in addition to a layered closure.
-
Service type: Complex wound repair with layered closure and possible scar revision or extensive tissue undermining
-
Typical site of service: Ambulatory surgical center, outpatient surgical suite, or hospital operating room, depending on clinical complexity and patient needs