Wiki E&M with suture removal

[N70QW]

Can someone explain the guidelines for coding a suture removal. The sutures were put in by another provider in the ER that billed the global. Patient then came to our office for removal. This is an established patient with our clinic. I have read a few posts about charging an E&M and not the suture removal, but not sure how or what needs to be documented for an E&M code, it was my understanding we could not bill for suture removal or E&M in the global, Do we need modifiers?

 

[maine4me]

I recently answered this same question for one of our family practice physicians. See below:

When billing for a suture removal there are two scenarios:
1. Patient had sutures placed in the ER, and came to us for the suture removal as instructed. This would be coded as a 99212.
2. Patient had sutures placed in the ER, came to us for suture removal as instructed, but has other problems which are addressed at the time of service, then a 99213 or higher would be billed. I would think this would not be the norm.
There is no need for a 25 modifier in either of these scenarios since only an E/M code is being billed.
Also, you would bill a higher E/M code if the patient has an active infection or other issues with the wound.
Diagnosis codes V53.82 and the code for the original injury should be reported.

There should be no worries about the global period, since you did not place the sutures.

Hope this is helpful.