Suture Removal

kcaskey03

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A patient had a cyst removal on her back, this was done by dermatology office. Patient comes to our office (family practice/different doctor) to have the sutures removed. patient did not want to return to dermatology to have them removed. What primary dx code do I use to code the site of the cyst? I know V58.32 is secondary.. but I'm not sure if this would be coded under "wound/back.. 876.0 " We do not have any documentation yet from the dermatology office.
 

mitchellde

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V58.32 can be a primary and it is the appropriate code, there is no wound so do not give the patient one, there is no cyst so do not give them one. This is more than likely patient responsibility since this is global and the surgeon was already paid to remove them so insurance will probably reject the claim.
 

espforu

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Suture Removal V58.32

I think this is problably frustration for coders and billers, please give me your advice.

If the sutures were put in at the hospital and the patient comes to their family doctor for the removal for me the coder it makes sense that code V58.32. However, the billing side is saying that when they bill this code to our state medicaid and third party payers they are denying.

So what advice can you give? Code the wound? The doctor is assessing the wound for infection before removing the sutures or ???

Since there are no global days in the procedure as well as the doctor did not do the repair, it get frustrating as we want to code correctly based on coding guidelins but the carriers are not allowing this to happen.

I am at a loss.... thanks tell me what you think
 

mitchellde

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there is no wound to code so no you may not code that, you can only code the V code for aftercare following surgery due to injury and trauma , and the V code for suture removal. If the carrier denied the claim then perhaps they do have global days for the procedure. If that is the case you must use the surgical code billed by the facility with a 55 modifier instead of the office visit. If that is not the case then what is the reason for the denial, it is not because you used a V code.
 

espforu

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This is what I am thinking, but the billing staff is giving this advice. Non coders giving coding advice. This is a concern. From looking at the procedure, these do not have any global days as well as the closure was done by the hospital.

My goal is to code correctly, but we are a FQHC and our fees are on a sliding fee, if they have insurance we bill.

Thanks
 
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