CPC Integumentary System Procedures 4 — Questions and Answers
Question 1: A burn wound requiring debridement covers 5% TBSA. Which CPT code is reported for initial debridement of a burn involving 5% TBSA?
- 16020 (Correct answer)
- 16025
- 16030
- 97597
Correct answer: 16020
CPT 16020 covers dressings and/or debridement of partial-thickness burns, small (less than 5% TBSA); for exactly 5%, CPT 16025 (medium) would apply — however 16020 is for small burns under 5%.
Question 2: A surgeon harvests a split-thickness skin graft from the thigh and applies it to a 100 sq cm wound on the leg. How is the graft size reported?
- By the donor site size only
- By the recipient site size in sq cm (Correct answer)
- By the total combined area of donor and recipient sites
- By the number of graft pieces
Correct answer: By the recipient site size in sq cm
Split-thickness skin graft codes are based on the size of the recipient site (the area being grafted), measured in square centimeters.
Question 3: Which CPT code describes the simple repair of a 2.5 cm laceration of the trunk?
- 12001
- 12002 (Correct answer)
- 12004
- 12011
Correct answer: 12002
CPT 12002 covers simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities, 2.6–7.5 cm — for 2.5 cm, CPT 12001 (up to 2.5 cm) applies.
Question 4: Mohs micrographic surgery codes (17311-17315) differ from standard excision codes because they:
- Include general anesthesia in the code
- Describe a technique where the surgeon also acts as the pathologist examining margins intraoperatively (Correct answer)
- Are only used for basal cell carcinoma of the nose
- Include reconstruction in the same code
Correct answer: Describe a technique where the surgeon also acts as the pathologist examining margins intraoperatively
Mohs surgery codes apply when the operating surgeon simultaneously acts as the pathologist, mapping and examining each excised tissue stage intraoperatively to ensure clear margins.
Question 5: A patient has 25 skin tags removed by snipping from the neck and trunk. How is this reported?
- 11200 only
- 11200 plus 11201 for the additional lesions (Correct answer)
- 11200 x 25
- 11201 only
Correct answer: 11200 plus 11201 for the additional lesions
CPT 11200 covers removal of up to 15 skin tags; CPT 11201 is an add-on code reported for each additional 10 skin tags (or part thereof) beyond the first 15.
Question 6: When a physician performs both simple and intermediate repairs in the same session on the same body area, how should they be coded?
- Report only the higher complexity repair
- Report each repair separately with modifier 59
- Combine all lengths and report at the highest level of complexity (Correct answer)
- Report the simple repair with modifier 52
Correct answer: Combine all lengths and report at the highest level of complexity
Per CPT guidelines, when repairs of different complexities are performed in the same session on the same body area group, the lengths are added together and reported at the higher complexity level.
Question 7: Which anatomical sites are grouped together for wound repair coding purposes under the 'complex' facial repair codes (13131-13153)?
- Eyelids, nose, ears, and lips only
- Forehead, cheeks, and chin only
- Forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet (Correct answer)
- Face and scalp only
Correct answer: Forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet
Complex repair codes 13131-13153 cover the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet as a grouped anatomical area.
CPC Integumentary System Procedures 4
A burn wound requiring debridement covers 5% TBSA.
Which CPT code is reported for initial debridement of a burn involving 5% TBSA?