Anesthesia Coding Alert

Question: How should I code sternal wire removal? The diagnosis is ICD-9 996.79 (Other complications of internal [biological] [synthetic] prosthetic device, implant and graft; due to other internal prosthetic device, implant and graft).

Iowa Subscriber Answer: Sternal wires are typically just below the skin, which means the physician conducts a fairly superficial procedure during their removal.

Because of that, coders often consider sternal wire removal to be an integumentary procedure and might report 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified). That seems fine if you code solely from CPT. But if you double-check the code in the Relative Value Guide -- and look further down the section -- you'll find a note with 00474 that states, "For sternal wire removal, see code 00470."

Based on that notation, 00470 (Anesthesia for partial rib resection; not otherwise specified) is the correct code for sternal wire removal.