The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Suture Removal from Upper Extremity
Safety considerations:
There are 3 categories of CPT Codes, and each category is divided further into different sections. For suture removal, its code falls under medicine sections in Category I, where the Suture Removal CPT Code is 99024. It is the code for post-operative visits that may include dressing change or suture removal.
A. The 99211 E/M visit is a nurse visit and should only be used by medical assistant or nurse when performing services such as wound checks, dressing changes or suture removal. CPT code 99211 should never be billed for physician services.
If the physician/group who is removing the sutures did not place the sutures, then the suture removal would be considered part of the E/M (Evaluation & Management). The ICD-10 for suture removal would be used. If the physician originally placed the sutures it is not separately reportable.
Since sutures are removed during the second visit, D0171 is appropriate. At the final visit, either D0171 can be used or D9430, since no treatment is performed. It is important to code for what you do whether or not the procedure is reimbursed. Precise documentation is necessary for both medical and legal reasons.
A. No, it will not matter. Even if the initial encounter by your practice is for suture removal, the 7th character will still be “D” because suture removal is considered part of the healing/recovery phase.
Follow-up suture removal is included in the laceration repair fee, but can be billed if the repair was performed elsewhere, such as in the emergency department.
Suture removal is determined by how well the wound has healed and the extent of the surgery. Sutures must be left in place long enough to establish wound closure with enough strength to support internal tissues and organs. The health care provider must assess the wound to determine whether or not to remove the sutures.
A nurse performs a suture removal on a patient whose sutures were placed at a different practice. Code 99211 could be reported for this service, since it describes the service better than any other CPT code (there is no specific CPT code for suture removal).
Code 99211 describes a face-to-face encounter with a patient consisting of elements of both evaluation (requiring documentation of a clinically relevant and necessary exchange of information) and management (providing patient care that influences, for example, medical decision making or patient education).
Answer: Billing for suture removal depends on several factors. The intermediate and complex repair codes have a global period of 10 days for the surgeon/practice who performed the original repair. Your physician is not in the global period of the physician who performed the repair.
If your payer allows, report S0630 Removal of sutures by a physician other than the physician who originally closed the wound, as long as a different physician than the one who placed the sutures removes them. Check with your insurer before submitting this code.
Removal of sutures is usually not a separately billable service.
As Rhonda Buckholtz, AAPC Vice President of Strategic Development, explains, “When the doctor sees the patient and develops his plan of care—that is active treatment. When the patient is following the plan—that is subsequent.
If a patient comes for postoperative treatment such as Suture Removal during Global Period of a set of procedures (usually 10 days for minor surgical procedures such as laceration repairs, and 90 days for major surgical procedures), code the visit using CPT Code 99024 , and there will be no problem.
CPT (Current Procedural Terminology) Codes are codes about diseases, health services, and procedures created by AMA (American Medical Association). On the other hand, ICD (International Classification of Diseases) Codes are also codes about diseases, health services, and procedures, but they are created by WHO (World Health Organization).
The code cannot be billed for doctor service. Also, to bill 99211, a provider should present (even if the person is only in the office and not seeing the patient) when the nurse or the medical assistant performs the service that may be a wound check, a dressing change, or suture removal.
Suture removal is usually a post-operative procedure. Suture removal is a part of a series of procedures under one diagnosis or one health case. However, there are some cases that suture removal is reimbursed separately. CPT Code for Suture Removal can be quite confusing for the health administration staff, the physician, the patient, ...
Per coding guidelines, you will not use Z codes for aftercare for injury or trauma, you use the trauma code with the subsequent 7th character. so if the original injury was an open fracture then you use that code , if the injury was a closed fracture, you use that code with the 7th character indicating subsequent encounter.
Z48.02 is an aftercare code and as such is not to be used for aftercare for a fracture.
Possible exceptions include: If the patient must be placed under general anesthesia to remove the sutures, you may report 15850 Removal of sutures under anesthesia (other than local), same surgeon or 15851 Removal of sutures under anesthesia (other than local), other surgeon.
If the same physician who placed the sutures removes them during the original procedure’s global period, you cannot report the removal separately.
Circumstances under which generally anesthesia would be medically necessary or appropriate for suture removal are rare. If your payer allows, report S0630 Removal of sutures by a physician other than the physician who originally closed the wound, as long as a different physician than the one who placed the sutures removes them.