TMPPM 2008 > Texas Medicaid Services > Physician > Procedures and Services

36.4.48 Suture of Wounds

Wounds are defined as a break or laceration of soft parts of body structures (i.e., skin) caused by violence or trauma to tissues. Wounds occur to all parts of the body and can be caused by accidents or under aseptic conditions, such as a surgical incision. The repair of wounds is defined as simple, intermediate, or complex. Simple repair involves the dermis and subcutaneous tissue and requires a one-layer closure. Intermediate repair requires some layered closure of deeper layers of subcutaneous tissue and superficial fascia. Complex repair involves more layered closure, debridement, extensive undermining, stints, or retention sutures. Wound closures may use sutures, staples, and/or wound adhesives.

Wound closures should be billed using the following procedure codes:

Multiple wounds on the same day will be paid the full-allowed amount for the major (largest) wound and one-half the allowed amount for each additional laceration.

No separate payment will be made for incision closures billed in addition to a surgical procedure when the closure is part of that surgical procedure.

No separate payment will be made for supplies in the office.

For the hospital-based emergency department, see the policy on "Supplies, Trays, and Drugs" .