this code is not payable by Medicare. If your provider didn't place the sutures, (another provider NOT in his group did) and your provider is removing them - he should be coding an E/M (probably a low level) with the V-code suture removal. AND documentation so support his services of course!
The answer depends on why the patient returned after the global. If it was due to a scheduling difficulty then no you cannot charge for suture removal. If it was due to slow healing then yes you can. actually it depends on "where" the patient had sutures placed. Some areas of the body require that sutures stay in over 10 days.
There is no specific code for suture removal. If your provider put in the sutures and it is within the global period you use CPT 99024 No charge office visit. Subsequently, question is, where can I get suture removal? Removing staples and sutures is essential for proper wound healing and infection control.
Wound dehiscence under the ICD-10-CM is coded T81. 3 which exclusively pertains to disruption of a wound not elsewhere classified.
It is S0630 Removal of sutures by a physician other than the physician who originally closed the wound (not valid for Medicare).
ICD-10 Code for Disruption of external operation (surgical) wound, not elsewhere classified, initial encounter- T81. 31XA- Codify by AAPC.
698A: Other mechanical complication of other specified internal prosthetic devices, implants and grafts, initial encounter.
The ICD-10 for suture removal would be used. If the physician originally placed the sutures it is not separately reportable. There is not a separate code that describes removal of sutures when the removal is not performed under anesthesia.
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.
998.83 - Non-healing surgical wound | ICD-10-CM.
Surgical wound dehiscence (SWD) has been defined as the separation of the margins of a closed surgical incision that has been made in skin, with or without exposure or protrusion of underlying tissue, organs, or implants.
code 12020 (Treatment of superficial wound dehiscence; simple closure), which has a global period of 10 days, or. code 13160 (Secondary closure of surgical wound or dehiscence; extensive or complicated), which has a 90-day global period.
Infection and inflammatory reaction due to internal fixation device of other site, initial encounter. T84. 69XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM T84.
V54. 01 Encounter for removal of internal fixation device.
ICD-10-CM Code for Mechanical loosening of internal prosthetic joint T84. 03.
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).
Cerclage removals done in the office with a local anesthetic get billed as part of the level of service. It's just the E&M code.
99024 - Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure. • Applies to surgeries with 90 and 10 day global periods. •
CPT® code 99211 is defined by the 2011 CPT Standard Edition manual as: "Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.
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, ...
Failure in suture or ligature during surgical operation 1 Y65.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2021 edition of ICD-10-CM Y65.2 became effective on October 1, 2020. 3 This is the American ICD-10-CM version of Y65.2 - other international versions of ICD-10 Y65.2 may differ.
Y65.2 describes the circumstance causing an injury, not the nature of the injury. This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter ...
Complications due to implanted mesh and other prosthetic materials 1 T83.7 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. 2 Short description: Complications due to implanted prstht mtrl 3 The 2021 edition of ICD-10-CM T83.7 became effective on October 1, 2020. 4 This is the American ICD-10-CM version of T83.7 - other international versions of ICD-10 T83.7 may differ.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
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.
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.