Caralee Posted Thu 26th of October, 2017 17:38:52 PM
Patient had Lumbar fusion 1 year ago done by other physician. Because of severe pain in back, our surgeon needs to remove retained lumbar suture possibly under Local anesthesia. What is the correct way to code this procedure since cpt code 15851 is for suture removal under anesthesia (other than Local). Thank you.
SuperCoder Answered Fri 27th of October, 2017 02:51:35 AM
It is best to report the services of your clinician by using an E/M codes 99201 - 99215 (Office or other outpatient visit for the evaluation and management of …).
If the patient is covered under insurance other than Medicare, you can also consider using S0630 (Removal of sutures; by a physician other than the physician who originally closed the wound) to let the payer know that your doctor is performing suture removal that was placed by another physician.
“S” codes are temporary, national codes for non-Medicare payers. Please check the payer’s guidelines to see if S0630 is a covered service to avoid denial. In case the payer is not covering the code, you can just resort to using an E/M code, as described above.