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suture removal w/opthalmological exam

  1. Default suture removal w/opthalmological exam
    Medical Coding Books
    two months new to opthalmology coding. question; patient outside global post op presents for est opth exam (92012) and oct. doctor also performs suture removal of undissolved sutures. we can bill an e/m with 25 modifier--icd-9; v58.32; correct? (documentation supporting)

  2. Default
    Are you billing the patient or the insurance with that V code?
    Suture removal is not separately billable. It's just thrown into the exam code.

  3. #3
    Default
    You can't bill suture removal removal seperately. it's bundled into the surgery code.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

  4. Default
    No matter how much time has past? What if the surgery was four or five years ago? Is there a time frame or can you never bill for the FB removal?

  5. Default
    Quote Originally Posted by Checkin02@yahoo.com View Post
    No matter how much time has past? What if the surgery was four or five years ago? Is there a time frame or can you never bill for the FB removal?

    It's not a FB. Someone put that suture there. Bill the removal as part of the exam.

  6. #6
    Location
    Lexington Kentucky Chapter
    Posts
    106
    Default
    Quote Originally Posted by vpcats View Post
    It's not a FB. Someone put that suture there. Bill the removal as part of the exam.
    Most payers (including CMS) consider suture removal bundled into the office visit or part of the global surgical fee; the only exception is when the suture is removed under general anesthesia -- 15850 (removal of sutures under anesthesia [other than local], same surgeon) or 15851 (removal of sutures under anesthesia [other than local], other surgeon). Check the American Academy of Ophthalmology (AAO) site for more regarding this issue.

    The foreign body removal codes (65205 - 65265) are for when an object enters the eye accidentally.

    David E. Keown, CPC, OCS

  7. Default
    I do not bill for ophthamology but for urgent cares and i know even if past the global period you can not bill for suture removal, if it was placed at your facility even if it is a different doc that removes it. It sounds like the pt had a exam of the eyes is this correct? So you would first code this the eye problem or exam, second the v-code for the suture removal and bill at the level of service for the eye exam only. If there was nothing else other than sut rem then the sercumstances i listed above are implied.

  8. Default Icd10 training for opthamology
    Does anyone know of specific training available ie: Dvd webinar or classes for icd10 training in opthamology.

    Thank you fellow coders

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