Wiki Can an OV be charged for suture removal if procedure has zero global days?

[traciecloutier@gmail.com]

Team,

I am a new coder (only 4 months) and sincerely need some help with this topic. Medicare has zero global days for a simple repair (12001). Does this translate into being able to charge a 99212 for suture removal? Supercoder indicates that Medicare removed suture removal from reimbursement and changed global period from 10 days to 0 days back in 2011. Other coders I have asked were still believing that there is a 10-day global for a simple repair this but CMS.gov contradicts that. If the global days are zero my understanding is that that means No surgical package and therefore suture removal would be a chargeable service. I appreciate all comments!

 

[mitchellde]

You are correct that yes you can charge to remove sutures from a simple repair. If your physician put them in then it is usually seen as a courtesty to remove them at no charge or at the least use a 99211. However if your provider did not put them in and he/she is taking them out then it is appropriate to charge a 99212 to remove them. If your nurse is removing sutures from another provider and your provider has not examined the patient to make an order that it is appropriate to remove the sutures then you cannot charge for that as it does not meet the requirements for incident-to.
In addition if this is a suture removal due to a trauma repair then do not use the Z code for suture removal, use the S code for the original injury with a D as the 7th character.

 

[traciecloutier@gmail.com]

Thank you very much for this clarification.