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Wiki Diagnosis for suture removal from laceration

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195
Location
Wahoo, NE
Best answers
0
Should Z48.02 or the laceration codes S91.115D, W20.8XXD be coded for this? The CPT code was S0630 (non-Medicare) since the sutures were placed by a different provider.
Profee coding, family practice clinic.
Patient comes in for suture removal. He was putting a pot away and accidentally dropped it and lacerated his toe. He was seen in the ER one week ago and had sutures placed.
ROS: Skin is negative for itching and rash.
Exam: Skin is warm and dry.
Assessment and Plan: Laceration of lesser toe of left foot without damage to nail. Sutures were removed.
 
Thanks, that's what I thought, and I would bill 99211 for Medicare, but for commercial insurance this clinic uses S0630 for suture removal by a different provider. Another coder is disagreeing and saying the diagnosis should be Z48.02 since there's no documentation of further treatment recommended for the laceration.
 
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