Choosing And Using A CPT Code For Suture Removal
Entering a CPT code for suture removal is something that is done by medical billing specialists. These codes help insurance companies to determine exactly what services were performed by medical providers and whether or not these were approved for payment under the insured's plan. If a code is entered in improperly, payment will most likely be denied. Although medical billing professionals do have the opportunity to correct their mistakes through the submission of appeals, multiple payment delays can be problematic for the doctors who use their services.
There are a number of considerations that people must make when selecting a code to enter for this particular procedure. It is first important to note that wounds are often cared for and closed up in emergency medical facilities. Most individuals will have their lacerations or cuts addressed in these facilities given their ability to provide urgent care for problems of this type.
Understanding this, once the emergency has been addressed, patients are not likely to revisit these locations. They are given instructions for care, any prescriptions that might be necessary and instructions to contact their normal doctors should future problems arise. Once discharged from these locations, they are not likely to return until another emergency event arises.
This means that most sutures are actually removed by different medical professionals from the ones that stitched the wounds up. Insurance companies will therefore receive several sets of billing statements and they will go through each one carefully. There are special codes that must be used in these events.
For instance, one type of coding specifically suggests that the sutures have been removed by the very same professional that has placed them in. Another states that these two distinctly different services were provided in separate locations by separate providers. Failing to catch this detail can result in billing delays that will be frustrating for both the medical provider and the contractor who has been hired to handle all billing issues. In fact, issues like these can even impact the patient's future ability to access services until payment problems have been resolved.
The CPT code for suture removal is just one example of how the current medical billing process can be extremely complex. The good news for many people in this industry and in related industries is the fact that new coding procedures are soon to be introduced. These are intended to be a part of universal health care offerings and they will ideally help to simplify these processes considerably.