Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Laceration size doesn't match code range (2.6-5cm required)
Very Common12002 specifically for 2.6-5cm simple repairs. Lac 2.5cm or less = 12001, 5.1-7.5cm = 12004. Documentation showing size outside 2.6-5cm range = wrong code. Common when size measured in inches and converted incorrectly.
Common Causes
- • Laceration 2.3cm documented - should be 12001 not 12002
- • Laceration 5.4cm - should be 12004 not 12002
- • Two separate lacs (1.5cm + 2cm = 3.5cm total) billed as single 3.5cm repair - should bill separately or by total length rules
Resolution Strategy
Document precise wound length: 'Laceration left forearm measuring 3.6cm repaired with simple closure, 5-0 nylon simple interrupted sutures.' Verify size in code range: 2.6-5cm = 12002. If size 2.5cm or less, rebill 12001. If 5.1-7.5cm, rebill 12004. For multiple lacs same anatomic area, may add lengths together following CPT guidelines. Cannot appeal if documented size clearly outside code range.
Relative Value Units (RVUs)
Calculator →
Clinical Information
When to Use
For simple, one-layer closure of superficial wounds between 2.6 cm and 7.5 cm in length involving skin and subcutaneous tissues
Common Scenarios
Documentation Requirements
- Total wound length measurement
- Wound location and depth
- Closure technique and materials
- Number of sutures or staples
- Wound preparation performed
Coding Guidelines
Common Modifiers
Bundling Rules
- Combine lengths of similar simple repairs in same anatomic grouping
- Local anesthesia bundled
- Simple debridement included
Exclusions
- Wounds requiring layered closure use intermediate codes
- Complex repairs involving extensive undermining use 13100 series
Coding Notes
Clinical scenarios
- Total wound length measurement
- Wound location and depth
- Closure technique and materials
- Total wound length measurement
- Wound location and depth
- Closure technique and materials
- Total wound length measurement
- Wound location and depth
- Closure technique and materials
Who are you?
Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
Automate Coding
Let OrbDoc AI automatically suggest codes from your clinical notes.
Patient? Check your bill.
Use our free analyzer to understand charges and spot errors.
Analyze My BillAsk OrbDoc AI
Get instant answers about 12002 - pricing, bundling rules, or billing questions.
Ask a QuestionFrequently Asked Questions
CPT 12002 is the billing code for "Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm". For simple, one-layer closure of superficial wounds between 2.6 cm and 7.5 cm in length involving skin and subcutaneous tissues
Medicare pays approximately $110.95 for CPT 12002 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 12002 has a total RVU of 4.24, broken down as: Work RVU 1.91, Practice Expense RVU 2.14, and Malpractice RVU 0.19. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 12002 is "Laceration size doesn't match code range (2.6-5cm required)". 12002 specifically for 2.6-5cm simple repairs. Lac 2.5cm or less = 12001, 5.1-7.5cm = 12004. Documentation showing size outside 2.6-5cm range = wrong code. Common when size measured in inches and converted incorrectly. Common causes include: Laceration 2.3cm documented - should be 12001 not 12002; Laceration 5.4cm - should be 12004 not 12002. Appeal success rate is approximately 10-30%.
Key documentation requirements for CPT 12002 include: Total wound length measurement; Wound location and depth; Closure technique and materials; Number of sutures or staples. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 12002: Combine lengths of similar simple repairs in same anatomic grouping. Local anesthesia bundled Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 12002 include: 51 (Multiple procedures same session), 59 (Distinct procedural service), 78 (Related procedure during postoperative period). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 12002 is 15-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.