R528

PDF page 566 / M16

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
SKIN AND SUBCUTANEOUS TISSUE
                                                                              Asst        Surg          Anae
    Zone 1 repair of digit
      A complex repair of zone 1 of the digit is repair of an injury without soft tissue loss that requires
      a minimum of 20 minutes of time to perform the repair procedure.
  Z189 Complex repair, digit, zone 1 repair, without soft tissue loss,
          per digit............................................................................... 101.15
       Note:
       1.Other repair fee codes are not eligible for payment in addition to Z189 for the same zone 1
         injury.
       2.For digit tip amputations or a zone 1 injury with soft tissue loss that would requirement
         advancement, graft or other surgical method of closure, see specific listings for surgical
         repair in the Integumentary System or Musckuloskeletal System Surgical Procedures
         sections of this Schedule.
       Payment rules:
       1.Wound and ulcer debridement services, Z128, Z129, and Z114 are not eligible for payment in
         addition to Z187, Z188 or Z189 for the same repair.
       2.Z187, Z188, and Z189 include removal of any foreign bodies in the wound, irrigation and
         debridement when rendered.
       3.Plastic Surgery Procedure services (i.e. R150, R151, R152, R153 and R154) are not eligible
         for payment for any laceration repair.
       Medical record requirements:
       Z187, Z188, and Z189 are only eligible for payment where the minimum time requirements
       involved in the repair service are documented in the patient's permanent medical record. The
       time requirement includes time to perform the repair exclusive of time spent rendering any
       other separately billable service.
       [Commentary:
       For laceration repairs that do not meet the above criteria for a complex laceration repair, see
       Repair of Lacerations listings on page M15.]
    Muscle repair
# R525 - Simple muscle repair(s) to include repair of involved skin .           6           97.05          7
# R528 - Complex (see General Preamble GP12)............................        6           I.C            6