CPT CODES

CPT Code 15850

CPT code 15850 is used for the removal of sutures by the same surgeon who originally placed them.

Table of Contents
What is CPT Code 15850
Does CPT 15850 Need a Modifier?
CPT Code 15850 Medicare Reimbursement
Are You Being Underpaid for 15850 CPT Code?
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What is CPT Code 15850

CPT code 15850 is used to indicate the removal of sutures by the same surgeon who initially placed them. This code is typically utilized when the surgeon who performed the original procedure is also responsible for the follow-up care involving the removal of stitches. It ensures that the healthcare provider is appropriately reimbursed for this specific post-operative service.

Does CPT 15850 Need a Modifier?

For CPT code 15850, which pertains to the removal of sutures by the same surgeon, the following modifiers may be applicable:

1. Modifier 58 - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Reason: This modifier is used when the suture removal is part of a planned, staged, or related procedure during the postoperative period.

2. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
- Reason: This modifier is used if the suture removal requires an unplanned return to the operating room during the postoperative period.

3. Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
- Reason: This modifier is used if the suture removal is unrelated to the original procedure and occurs during the postoperative period.

4. Modifier 24 - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
- Reason: This modifier is used if the suture removal involves an unrelated evaluation and management service during the postoperative period.

5. Modifier 25 - Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
- Reason: This modifier is used if the suture removal involves a significant, separately identifiable evaluation and management service on the same day as another procedure.

These modifiers help ensure accurate billing and reimbursement by providing additional context about the nature of the suture removal procedure.

CPT Code 15850 Medicare Reimbursement

The CPT code 15850, which involves the removal of sutures by the same surgeon, is generally not reimbursed separately by Medicare. According to the Medicare Physician Fee Schedule (MPFS), this service is typically considered part of the global surgical package and is not separately payable. Medicare Administrative Contractors (MACs) follow these guidelines and will usually bundle this service with the original surgical procedure, meaning that no additional reimbursement is provided for CPT code 15850.

Are You Being Underpaid for 15850 CPT Code?

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