Plastic and Vascular Surgery:
The following conditions are necessary for 06075, 06076 or 06077 to apply:
i) A layered closure* is required and at least one of:
a) Injuries involving necrotic tissue requiring debridement such that simple suture closure is precluded; or
b) Injuries involving tissue loss such that simple suture is precluded; or
c) Wounds requiring tissue shifts for closure aside from minor undermining or advancement flaps; or
d) Skived, ragged or stellate wounds where excision of tissue margins is necessary to obtain 90 degree closure; or
e) Contaminated wounds that require excision of foreign material, or
ii) Lacerations requiring layered closure and key alignment sutures involving critical margins of the eyelid, nose, lip, oral commissure or ear; or
iii) Lacerations into the subcutaneous tissue requiring alignment and repair of cartilage and layered closure.
iv) A note record indicating how the service meets the above criteria must accompany claims billed under these fee items.
* A layered closure is required when the defect would require too much tension for an acceptable primary closure. It involves at least two layers of deep dissolving sutures to close off dead space and take tension off the wound. A deep cartilage closure is also considered a layered closure.