Suture Removal Is Rarely Reported Separately
- By admin aapc
- In Coding
- September 30, 2013
- Comments Off on Suture Removal Is Rarely Reported Separately
Removal of sutures is usually not a separately billable service. An exception may occur if the patient must be placed under general anesthesia to remove the sutures (15850 Removal of sutures under anesthesia (other than local), same surgeon or 15851 Removal of sutures under anesthesia (other than local), other surgeon). There are very few circumstances under which general anesthesia would be medically necessary or appropriate for suture removal, however.
If the same physician who placed the sutures removes them during the original procedure’s global period, you cannot bill the removal separately. At best, you may report 99024 Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure. Payers usually assign no value to the code, but reporting it allows you to track the visit.
If a different physician removes the sutures, the removal becomes part of any evaluation and management (E/M) service reported.
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On January 1, 2011 the 10 day global period for simple wound repairs (12001-12018) was eliminated allowing for billing of follow-up visits and suture removal codes. Wouldn’t that be an exception to this scenario?
I am in agreement with Virginia…I thought that due to the elimination of the 10 day global period for Simple Wound Repairs, that billing follow-up visits for such Suture Removals were allowed. Is this incorrect?
I am in agreement I understand it to read it now is a billable procedure for return care of simple wounds. However our agency has not been billing it as such.
I do know of many billing agencies that have been billing this out. My question is how responsible are the Physicians who agencies are billing it? Seems CMS was unclear in their removal of Global care.
Now that the post-op days have been removed from simple repair codes it is POSSIBLE to bill an E/M when the patient returns, but only if one is documented. If the note simply says “Pt. returns for suture removal” with no further detail you’ve got nothing. But if the note states “Patient returns s/p repair of 3cm forehead wound sustained in bicycle accident. Wound edges appear well-approximated. No erythema or other signs/sx of infection. Sutures removed.” …you have a 99212.
My providers frequently bill for suture removal when we do not do the procedure, but no one is paying it. Should I upcode the visit?
The statement describes procedures, “during the original procedure’s global period”. If the procedure you are dealing with has no global period; I would not think this would apply to your situation.
If he is in global period I think you can not bill for this visit. If he is out of Global period that you can bill.
If surgery is past global period and a non absorbable stich needs to come out is there a procedure code and can you bill if done in outpatient facility under local sedation?
Can anyone help to find out an alternate code for S0630 for Medicare.
Hi Anandhi,
Please post this on the AAPC Member Forums. I bet you’ll get an answer.