Wiki Modifier needed for suture removal

[yammas60]

In a skilled nursing facility. If one of our residents goes out to have surgery, and our staff physician assistant removes the sutures weeks later, does this E&M visit by the PA have a 59 modifier added to it? Can someone please clarify this for me. Thank you.

 

[mitchellde]

You cannot add a 59 to an E&M level. and if the surgeon did not request that your PA remove them then you cannot bill for it because the surgeon is being paid via the global reimbursement to provide all post op care which includes the removal of sutures when done in the global. If the surgeon does transfer the post op care to you (in writing) then you can bill using the surgical code with the 55 modifier if this is still in the global. If the global has expired and the sutures need removal then you use the E&M code with no modifier.

 

[armen]

I work in a skilled nursing facility. If one of our residents goes out to have surgery, our staff physician assistant removes the sutures weeks later. My supervisor believes that this E&M visit by the PA should have a 59 modifier added to it. Can someone please clarify this for me. Thank you.

I dont think 59 is ever used with E/M. Dx for suture removeal would be:
V58.32 Encounter for removal of sutures
Encounter for removal of staples