Steri-Strips are reinforced adhesive wound closures used to manage minor skin wounds. These strips pull the edges of a laceration or incision together, promoting healing without the need for sutures or staples. Determining the correct coding category for this service is highly dependent on the context of their use in the clinical setting. The category assigned is not a single code but rather a decision tree based on whether the strips are the sole method of closure or merely an adjunct to a more complex procedure. This variability makes the coding of adhesive strip application one of the most frequently misunderstood billing topics in wound care.
Why Steri-Strip Application is Usually Bundled
The vast majority of Steri-Strip applications performed in a medical environment are considered an inclusive part of a larger service and are not billed separately. This occurs when the strips are used as a dressing following a primary closure method, such as sutures or surgical staples. In this scenario, the application is automatically “bundled” into the payment for the main procedure.
This bundling is rooted in the concept of the “global surgical package,” which covers all necessary, routine, and typical services provided by a surgeon during and immediately following a procedure. Standard wound closure methods that are incidental to a primary surgery, like using adhesive strips for added support, fall under this package. The reimbursement for the complex, primary procedure already accounts for the time and materials used for the simple strip application.
Even in the context of minor surgical procedures, such as a skin biopsy or the excision of a small lesion, the subsequent closure with adhesive strips is typically included in the primary excision code. The logic is that any simple closure technique used to complete the surgical service is integral to the overall procedure. CPT codes in the repair section (e.g., the 12000 series) explicitly cover the use of adhesive strips in combination with primary closure methods like sutures or tissue adhesives.
Coding Categories for Stand-Alone Application
The category of codes assigned for Steri-Strip application is only distinct when the adhesive strips are the sole material used to close a wound. For minor, superficial wounds that do not require deep closure, the application of Steri-Strips does not typically qualify for a separate procedural code from the CPT wound repair section (12001-13160). The CPT manual specifies that wound closure utilizing adhesive strips as the only repair material must be coded using Evaluation and Management (E/M) services.
This means the service is captured under the E/M code that describes the overall encounter, such as an office visit (99202–99499) or an emergency department visit. The clinical work performed, including the wound cleaning, examination, medical decision-making, and the simple application of the strips, is all encompassed by the E/M code chosen for that visit. The complexity of the E/M code is determined by factors like the history taken, the physical examination performed, and the complexity of the medical decision-making required for the patient’s entire complaint.
If the wound is deep enough to necessitate a formal repair, but the clinician chooses to use a tissue adhesive, such as 2-cyanoacrylate (Dermabond), instead of sutures, a CPT repair code can be used. However, adhesive strips alone do not meet the criteria for a billable repair procedure, which is why the code category defaults back to the E/M service. The decision to use E/M codes instead of a surgical repair code reflects that a Steri-Strip-only closure is considered a minimally invasive service incidental to the patient’s visit.
Differentiating Supply Codes and Procedural Codes
It is important to distinguish between the procedural service of applying the strips and the supply item itself. The procedural code category is typically a CPT code for a repair or an E/M service. The Steri-Strips as a physical item are considered medical supplies, which fall under the Healthcare Common Procedure Coding System (HCPCS) Level II.
Individual supplies are sometimes represented by HCPCS codes for tape or other related adhesive materials. However, the primary category of code assigned for the application is always a procedural code (CPT) for the service rendered, not the supply code (HCPCS) for the strips themselves. Payers rarely allow separate billing for low-cost, routine supplies like adhesive strips in an outpatient setting, as their cost is generally expected to be included in the reimbursement for the main procedure or the E/M visit. The focus is always on the service provided to the patient, which is categorized as either a bundled component of a larger surgery or an integral part of the overall clinical evaluation and management.