Intermediate Repair after Lesion Removal

What is the documentation requirements for billing intermediate repair after lesion removal?

I have always told provider that a statement such as "intermediate repair" or "layered repair" is not enough. They must indicate repair included the deeper layers of the subcutaneous etc.

I was googling this and found one presentation that indicated "intermediate repair" is enough to bill. This is what was documented. Is this acceptable?

The surgically created wound, measuring 15 mm in greatest dimension, was closed in multiple layers, using 5-0 vicryl for the dermis and 5-0 nylon for the skin.

Also, is there a limit in size of repair before you can bill repair? This would come out 1.5cm.

Your assistance is greatly appreciated.

re: Intermediate Repair after Lesion Removal

Multiple layers usually indicate intermediate. Show the physician the definitions in the CPT® manual.
Payers will determine policy on repairs after an excision. For any given lesion there should be only one type of lesion excision reported. Excision is reported as full-thickness (through the dermis) removal of a lesion including margins, and including simple (non-layered) closure when performed.
Billing for the excision of benign lesions with a lesion diameter of 0.5 cm or less (CPT®
11400, 11420, 11440) includes service for the simple, intermediate or complex repairs. In other words, separate billing for simple, intermediate, or complex repairs (CPT® 12001-12018) should not be reported with CPT® codes 11400, 11420 and 11440 when the diameter is 0.5 cm or less.
Billing for the excision of a benign lesion with a lesion diameter greater than 0.5 cm or
the excision of malignant lesion of any size does not include the service for intermediate or medically necessary complex repairs CPT® codes 12031-12057. Separate billing for repair codes 13100-13152 may be reported with CPT® codes 11401–11406, 11421-11426, 11441-11446, and 11600-11646.

re: Intermediate Repair after Lesion Removal

This is from a previous response.

Billing for the excision of benign lesions with a lesion diameter of 0.5 cm or less (CPT® 11400, 11420, 11440) includes service for the simple, intermediate or complex repairs.

Is this before the margins are taken? For example if lesion is .5cm but the take 1mm margins?

This occurs alot.

Thank you for your assistance.