Comprehensive Breakdown of Laceration Repair CPT Codes and Categories

Laceration repairs are among the most common procedures performed in medical settings across the United States. From minor cuts to complex injuries requiring intricate repair, the number of cases seeking laceration treatment is virtually uncountable. 

Laceration repair can range from straightforward procedures, such as closing a superficial wound, to highly complex repairs involving deep structures and multiple layers. The associated CPT codes are numerous, and while memorizing them all might seem impossible, aligning the right codes with proper documentation is essential for accurate billing and reimbursement.

In this comprehensive guide, we will explore the categories of laceration repair codes and their respective details.

Classification of Laceration Repair CPT Codes Based on Categories

Laceration repair CPT codes are divided into three main categories: 

• Simple Repairs

• Intermediate Repairs

• Complex Repairs

These categories define the complexity of the repair procedure, the layers involved, and the documentation required.

CPT Codes for Laceration Repair Simple Laceration CPT Codes (12001-12021) 

Simple laceration repairs involve superficial wounds primarily affecting the epidermis, dermis, or subcutaneous tissues. These procedures typically require a single-layer closure using sutures, staples, or tissue adhesives.

CPT Codes for Laceration of Scalp, Neck, Axillae, External Genitalia, Trunk, and/or Extremities (Including Hands and Feet)

CPT 12001:

• Description: Simple repair of a wound 2.5 cm or less.

• Example: Suturing a small cut on the hand after an injury with minimal bleeding.

• Documentation Tip: Record wound length and anatomical location for accurate coding.

CPT 12002:

• Description: Simple repair of a wound 2.6 cm to 7.5 cm.

• Example: Repairing a medium-sized laceration on the trunk caused by a fall.

• Note: Ensure measurements are precise, as repairs over 7.5 cm fall into the next code category.

CPT 12004:

• Description: Simple repair of a wound 7.6 cm to 12.5 cm.

• Example: Closing a long laceration on the forearm from a sharp object.

• Billing Insight: Repairs nearing 12.5 cm should be re-measured to avoid undercoding.

CPT 12005:

• Description: Simple repair of a wound 12.6 cm to 20.0 cm.

• Example: Suturing a significant gash on the leg caused by an accident.

• Tip: Larger wounds may require additional documentation on complexity.

CPT 12006:

• Description: Simple repair of a wound 20.1 cm to 30.0 cm.

• Example: Repairing an extended laceration across the lower back.

• Documentation Need: Clearly note the length and describe any minor contamination.

CPT 12007:

• Description: Simple repair of a wound over 30.0 cm.

• Example: Extensive repair of a laceration along the side of the torso.

• Key Insight: Repairs of this size require meticulous documentation for billing accuracy.

CPT Codes for Laceration Repair on Face, Ears, Eyelids, Nose, Lips, and/or Mucous Membranes

1. CPT 12011:

   • Description: Simple repair of a wound 2.5 cm or less.

   • Example: Closing a small laceration on the forehead with sutures.

   • Note: Facial repairs often require detailed documentation due to cosmetic implications.

2. CPT 12013:

   • Description: Simple repair of a wound 2.6 cm to 5.0 cm.

   • Example: Repairing a medium-sized cut on the cheek from a fall.

   • Billing Advice: Check if additional anesthesia services are included or separately billable.

3. CPT 12014:

   • Description: Simple repair of a wound 5.1 cm to 7.5 cm.

   • Example: Suturing a larger wound on the lip caused by a blunt injury.

   • Critical Detail: Ensure documentation specifies the depth and cleanliness of the wound.

4. CPT 12015:

   • Description: Simple repair of a wound 7.6 cm to 12.5 cm.

   • Example: Repairing a lengthy laceration across the jawline.

   • Tip: Check for potential intermediate repair if deeper layers are involved.

5. CPT 12016:

   • Description: Simple repair of a wound 12.6 cm to 20.0 cm.

   • Example: Closing an extended facial laceration caused by a sharp object.

   • Insight: For longer wounds in cosmetic areas, ensure appropriate modifiers are applied.

6. CPT 12017:

   • Description: Simple repair of a wound 20.1 cm to 30.0 cm.

   • Example: Repairing an extended laceration along the neck.

   • Documentation Focus: Note if the wound required additional cleaning before closure.

7. CPT 12018:

   • Description: Simple repair of a wound over 30.0 cm.

   • Example: Extensive facial repair following trauma.

   • Key Consideration: Thoroughly document the extent of the repair, particularly in cosmetic areas.

CPT Codes for Laceration Repair Intermediate Laceration Repair CPT Codes (12031-12057)

Intermediate laceration repairs are more complex than simple repairs, requiring layered closure of one or more deeper layers of subcutaneous tissue and superficial fascia in addition to the skin closure. These codes are also used for wounds that require significant cleaning or decontamination due to heavy contamination.

CPT Codes for Laceration Repair Scalp, Axillae, Trunk, and/or Extremities (Excluding Hands and Feet)

CPT 12031:

• Description: Intermediate repair of a wound 2.5 cm or less.

• Example: Closing a small, contaminated laceration on the trunk requiring layered closure.

• Documentation Tip: Clearly note contamination and the need for layered closure.

CPT 12032:

• Description: Intermediate repair of a wound 2.6 cm to 7.5 cm.

• Example: Suturing a moderately contaminated wound on the axillae with deeper tissue involvement.

• Billing Insight: Ensure that the wound's complexity is described in detail.

CPT 12034:

• Description: Intermediate repair of a wound 7.6 cm to 12.5 cm.

• Example: Repairing a larger laceration on the back caused by trauma, requiring layered closure.

• Key Tip: Note if any additional services, such as extensive cleaning, were performed.

CPT 12035:

• Description: Intermediate repair of a wound 12.6 cm to 20.0 cm.

• Example: Suturing a significant injury on the thigh that required cleaning and layered closure.

• Documentation Need: Specify wound length and cleaning measures taken.

CPT 12036:

• Description: Intermediate repair of a wound 20.1 cm to 30.0 cm.

• Example: Repairing an extended, contaminated laceration along the abdomen.

• Important Note: Ensure precise length measurement and description of layered closure.

CPT 12037:

• Description: Intermediate repair of a wound over 30.0 cm.

• Example: Closing a long laceration along the back caused by blunt trauma.

• Key Insight: For exceptionally large wounds, document all steps taken in the repair process.

CPT Codes for Laceration Repair  Neck, Hands, Feet, and/or External Genitalia

CPT 12041:

• Description: Intermediate repair of a wound 2.5 cm or less.

• Example: Closing a contaminated laceration on the neck requiring layered closure.

• Tip: Provide detailed documentation of the layers involved.

CPT 12042:

• Description: Intermediate repair of a wound 2.6 cm to 7.5 cm.

• Example: Suturing a moderately complex wound on the hand requiring deeper closure.

• Billing Insight: Avoid upcoding unless the repair truly involves intermediate closure.

CPT 12044:

• Description: Intermediate repair of a wound 7.6 cm to 12.5 cm.

• Example: Repairing a foot laceration with multiple contaminated layers.

• Documentation Need: Note contamination and techniques used for cleaning.

CPT 12045:

• Description: Intermediate repair of a wound 12.6 cm to 20.0 cm.

• Example: Closing a deep laceration on the neck caused by a sharp object.

• Tip: Clearly outline the necessity for layered closure.

CPT 12046:

• Description: Intermediate repair of a wound 20.1 cm to 30.0 cm.

• Example: Suturing a large, complex injury to the hand with contamination.

• Billing Insight: Provide detailed length and complexity to support the code.

CPT 12047:

• Description: Intermediate repair of a wound over 30.0 cm.

• Example: Repairing a long, contaminated laceration on the external genitalia.

• Key Detail: Extensive documentation ensures proper reimbursement for extensive wounds.

Read Out: Wound Care Billing & Coding Guidelines

CPT Codes for Laceration Repair Face, Ears, Eyelids, Nose, Lips, and/or Mucous Membranes

CPT 12051:

• Description: Intermediate repair of a wound 2.5 cm or less.

• Example: Closing a contaminated facial wound with layered closure for better healing.

• Documentation Tip: Detail the cosmetic considerations involved.

CPT 12052:

• Description: Intermediate repair of a wound 2.6 cm to 5.0 cm.

• Example: Suturing a medium-sized, contaminated laceration on the lip.

• Key Detail: Note the anatomical region and its cosmetic importance.

CPT 12053:

• Description: Intermediate repair of a wound 5.1 cm to 7.5 cm.

• Example: Repairing a larger wound on the cheek caused by trauma.

• Billing Insight: Confirm layered closure necessity to avoid miscoding.

CPT 12054:

• Description: Intermediate repair of a wound 7.6 cm to 12.5 cm.

• Example: Suturing a lengthy laceration on the eyelid for optimal cosmetic outcomes.

• Tip: Always emphasize the complexity when coding intermediate facial repairs.

CPT 12055:

• Description: Intermediate repair of a wound 12.6 cm to 20.0 cm.

• Example: Repairing a significant laceration on the nose with deeper tissue involvement.

• Documentation Need: Include a clear description of the complexity.

CPT 12056:

• Description: Intermediate repair of a wound 20.1 cm to 30.0 cm.

• Example: Closing an extended facial laceration after a motor vehicle accident.

• Billing Tip: Emphasize the layers repaired and the anatomical region.

CPT 12057:

• Description: Intermediate repair of a wound over 30.0 cm.

• Example: Repairing a large, contaminated lip laceration requiring multi-layered closure.

• Key Consideration: Detailed documentation supports the complexity of the repair.

CPT Codes for Laceration Repair Complex Laceration Repair CPT Codes (13100–13160)

Complex laceration repairs involve more than just simple or intermediate closures. These procedures require significant expertise, addressing deeper structures like muscles, nerves, or blood vessels, and often involve extensive debridement, undermining, or revision of scar tissue.

CPT Codes for Laceration Repair Trunk (CPT 13100–13102)

CPT 13100:

• Description: Complex repair of a wound 1.1 cm to 2.5 cm.

• Example: Repairing a small yet deep laceration on the trunk involving extensive undermining.

CPT 13101:

• Description: Complex repair of a wound 2.6 cm to 7.5 cm.

• Example: Suturing a moderate trunk wound requiring undermining and debridement.

CPT +13102:

• Description: Each additional 5 cm or less.

• Example: Extending the repair of a laceration larger than 7.5 cm.

CPT Codes for Laceration Repair Scalp, Arms, and/or Legs (CPT 13120–13122)

CPT 13120:

• Description: Complex repair of a wound 1.1 cm to 2.5 cm.

• Example: Repairing a deep scalp laceration with undermining.

CPT 13121:

• Description: Complex repair of a wound 2.6 cm to 7.5 cm.

• Example: Closing a contaminated leg wound with multiple layers.

CPT +13122:

• Description: Each additional 5 cm or less.

• Example: Adding length for an extended laceration on the arm.

CPT Codes for Laceration Repair Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands, and/or Feet (CPT 13131–13133)

CPT 13131:

• Description: Complex repair of a wound 1.1 cm to 2.5 cm.

• Example: Suturing a wound on the cheek requires deep tissue repair.

CPT 13132:

• Description: Complex repair of a wound 2.6 cm to 7.5 cm.

• Example: Repairing a deep chin laceration involving fascia.

CPT +13133:

• Description: Each additional 5 cm or less.

• Example: Extending the closure of a complex neck laceration.

CPT Codes for Laceration Repair Eyelids, Nose, Ears, and/or Lips (CPT 13151–13153)

CPT 13151:

• Description: Complex repair of a wound 1.1 cm to 2.5 cm.

• Example: Repairing a lip laceration requiring intricate closure for cosmetic purposes.

CPT 13152:

• Description: Complex repair of a wound 2.6 cm to 7.5 cm.

• Example: Repairing an eyelid laceration with precise alignment of tissue layers.

CPT +13153:

• Description: Each additional 5 cm or less.

• Example: Extending the repair of a complex ear laceration.

Repair Procedure on the Vagina

Repair procedures on the vagina are often required following traumatic injuries, surgeries, or childbirth-related lacerations. These procedures involve meticulous attention to anatomical structures and coding precision to ensure proper reimbursement.

Common CPT Codes for Vaginal Repairs

CPT 59300:

• Description: Episiotomy or vaginal repair following delivery.

• Usage: Used when the vaginal or perineal repair is performed post-childbirth for first- or second-degree lacerations.

• Documentation Needs: Clearly document the type of laceration repaired and its degree.

CPT 12041–12047 (Intermediate Repair Codes):

• Description: Used for layered closures involving vaginal mucosa and submucosal tissue.

• Example: Repairing a second-degree laceration involving vaginal muscles.

• Note: Intermediate repair codes are applicable when deeper layers are involved but the repair is not excessively complex.

CPT 13131–13133 (Complex Repair Codes):

• Description: Used for more complex vaginal repairs involving multiple layers or structures like the anal sphincter.

• Example: Fourth-degree laceration repair requiring meticulous reattachment of deeper structures.

• Documentation Tip: Highlight the complexity of the repair, including scar revision or involvement of sphincter muscles.

CPT 57200–57210 (Vaginal Reconstructive Surgery):

• Description: These codes cover extensive repairs or reconstruction procedures, often following trauma or for prolapse repair.

• Example: Repairing extensive vaginal damage due to trauma or childbirth.

Procedure Specific Laceration Repair

Repair Techniques

Laceration repairs can utilize various techniques, including sutures, tissue adhesives (e.g., Dermabond), or Steri-Strips. The chosen method depends on the wound's location, depth, and complexity. Below is a breakdown of specific techniques and related CPT coding:

Laceration Repair with Dermabond (Tissue Adhesives)

• CPT Code: Typically CPT 12001–12018 (Simple Repair Codes).

• Description: Tissue adhesives are often used for superficial wounds as an alternative to sutures.

• Billing Insight: When Dermabond or similar adhesives are used, the procedure is billed under the simple laceration repair codes. Do not bill separately for the adhesive, as it is included in the repair.

Laceration Repair with Glue

• CPT Code: Same as above.

• Note: The use of glue like Dermabond is considered a form of simple repair; no unique CPT code exists specifically for glue application.

• Billing Insight: Ensure proper documentation specifying the adhesive's use.

Laceration Repair with Steri-Strips

• CPT Code: Steri-Strips alone are not billable as laceration repair; they are included in the evaluation and management (E/M) service.

• Description: Steri-Strips are used for minor, superficial wounds and do not qualify for separate repair coding.

• Billing Insight: If used in conjunction with sutures or other closures, the repair may still be coded appropriately under the laceration repair codes.

Obstetric and Delivery-Related Repairs

CPT Code for Laceration Repair After Delivery (59300)

• Description: CPT 59300 is used for episiotomy or vaginal repair during delivery.

• Application: Includes first- or second-degree vaginal laceration repairs as part of the global delivery package.

• Billing Insight: If repairs exceed routine procedures (e.g., third- or fourth-degree tears), they may require separate documentation and billing with appropriate codes.

Third- and Fourth-Degree Repairs

• CPT Codes: Use intermediate (12041–12047) or complex repair codes (13131–13133) for layered closure involving deeper structures such as the anal sphincter.

• Documentation: Clearly outline the degree of the tear and the layers involved in the repair.

General Codes

CPT Code for Suture Placement

• Common CPT Codes: Use simple, intermediate, or complex laceration repair codes depending on the wound’s complexity:

Laceration Repair on the Floor of the Mouth

• CPT Code: Use the intermediate repair codes (12041–12047) for mucosal layers or complex codes (13131–13133) if involving deeper oral structures.

• Key Insight: Mucosal repairs require detailed documentation of the wound's depth and location.

Final Words

Understanding and applying laceration repair codes accurately is critical for ensuring timely reimbursement and avoiding claim denials. This guide breaks down the complexities to provide a clear roadmap for coding success. Still, handling billing in-house can strain your resources—outsource to seasoned professionals like HMS USA LLC  who specialize in wound care billing to save time and money while maintaining compliance.