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Suture removal at PCP & coding visit

  1. #1
    Location
    Columbus, Ohio
    Posts
    77
    Post Suture removal at PCP & coding visit
    Medical Coding Books
    Hi I need assistance with what is hopefully an easy one.

    Pt went to ER after a fall (E885.9) and received 3 sutures to the hand due to a laceration (822.0). The pt followed up with PCP and had stitches removed.

    Can I code V58.32 + 822.0 & E885.9 with a CPT for suture removal (??? i need help locating) Unfortunately I only have books and no fancy software.

    Any help is appreciated! Thanks!!!

    Stephanie W, CPC

  2. Default
    What was the time between having them put in and removed there is a 10 day global peroid. So you might not be able to code for the removal.

  3. #3
    Location
    Columbus, Ohio
    Posts
    77
    Default
    Quote Originally Posted by cingram View Post
    What was the time between having them put in and removed there is a 10 day global peroid. So you might not be able to code for the removal.
    They were put in on the 5th and removed on the 14th. This is within the 10 days but because they were put in in the ER and removed by a different provider in the office (not part of the same facility or practice), can't the provider who removed the sutures be separately reimbursed?

    Stephanie W, CPC

  4. Default
    yes but if you are still within the global peroid you will not be paid for it.

  5. #5
    Location
    Columbia, MO
    Posts
    12,844
    Default
    First you do not bill the codes for the acute injury nor the E code only use the V58.32 there is no need for anything else for the diagnosis. The wound is no longer there. For the CPT code if it is within the global of another surgeon, then you need documentation in the patient's chart that the surgeon that put the sutures in requested that you remove them. Sometimes the ER will put this in the patient's discharge instructions such as "return to PCP for suture removal". You make a copy of this and scan it into the record, or get a verbal order from the ER to remove the sutures. Then
    in box 19 of the 1500 put a note that states your were requested to remove the sutures (28 characters or less!) THEN
    you will use the same CPT code that was used to put the sutures in, and attach a 55 modifier.
    Remember as of Jan 1 2011 CMS deemed most minor repairs now have a 0 global timeframe so check first. If there is no global then you bill and OV if you are in a global then you bill as I have stated.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Location
    Columbus, Ohio
    Posts
    77
    Default
    Quote Originally Posted by mitchellde View Post
    First you do not bill the codes for the acute injury nor the E code only use the V58.32 there is no need for anything else for the diagnosis. The wound is no longer there. For the CPT code if it is within the global of another surgeon, then you need documentation in the patient's chart that the surgeon that put the sutures in requested that you remove them. Sometimes the ER will put this in the patient's discharge instructions such as "return to PCP for suture removal". You make a copy of this and scan it into the record, or get a verbal order from the ER to remove the sutures. Then
    in box 19 of the 1500 put a note that states your were requested to remove the sutures (28 characters or less!) THEN
    you will use the same CPT code that was used to put the sutures in, and attach a 55 modifier.
    Remember as of Jan 1 2011 CMS deemed most minor repairs now have a 0 global timeframe so check first. If there is no global then you bill and OV if you are in a global then you bill as I have stated.
    Woo Thank You! Ok another Q the ERs wording was "follow-up with PCP" is that good enough to justify the suture removal at the providers office?

  7. #7
    Location
    Columbia, MO
    Posts
    12,844
    Default
    Quote Originally Posted by stephanie7480 View Post
    Woo Thank You! Ok another Q the ERs wording was "follow-up with PCP" is that good enough to justify the suture removal at the providers office?
    Yes it will do fine, just keep a copy in your chart.

    Debra A. Mitchell, MSPH, CPC-H

  8. Default
    so I would use codes used for surgery: 63047, 22630 and 22632 with modifier 55 for staple removal? Surgeon sent patient to pcp for that. Or can I use ov with modifer?

  9. #9
    Location
    Columbia, MO
    Posts
    12,844
    Default
    The 55 modifier can be applied to a surgery code only.

    Debra A. Mitchell, MSPH, CPC-H

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