Wiki Suture CPT question

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Suture CPT question

When reporting for suture removal, you have the option of reporting the same code that described the initial procedure and appending modifier 55 Postoperative management only. Postoperative care usually accounts for approximately 10 percent of the procedure’s value.

Returning to our example above, suppose an emergency department (ED) physician performed the wound repair (12052), but the patient’s primary care physician (PCP) removed the sutures at a later date. In an ideal world, the PCP would report 12052-55 for postoperative care (including suture removal).

An alternative tactic is to report a low-level evaluation and management (E/M) service for a problem-focused visit, especially when suture removal occurs outside of the global period. As always, documentation must support medical necessity for the visit.

Sutures are removed under anesthesia.
This circumstance is rare, but when documented and supported by medical necessity, you may report 15850 Removal of sutures under anesthesia (other than local), same surgeon or 15851 Removal of sutures under anesthesia (other than local), other surgeon, depending on whether the same surgeon who performed the initial procedure, or a different surgeon, removed the sutures.

Payer accepts S codes.
Some private payers (but not Medicare) may accept S0630 Removal of sutures by a physician other than the physician who originally closed the wound for suture removal, as long as the physician who removes the sutures isn’t the physician who placed them.

In any case, when suture removal is the primary reason for the patient encounter, report V58.3 Encounter for other and unspecified procedures and aftercare; attention to surgical dressings and sutures as the first-listed diagnosis.

TammyHF

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Is there a surture removal CPT for when a physician removes sutures that they did not put in? I can find suture removal under anesthsia CPT code but this patient needs sutures removed that were put in by an ER doctor.
Thank you,
Tammy:confused:
 

bsuse

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suture removal

you would use a 99211 if a nurse removed the sutures. if a doctor sees the patient to remove them, then you can bill a higher level if documentation supports the level. there is no specific code for removing sutures.:)
 

coder911

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There is a HCPCS code for that service - it is noncovered by Medicare, and who knows if any other payors consider it, but here it is: S0630
 

gigiduffy

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BCBS will pay for S0630 as long as the sutures were not placed by the doc who is removing - otherwise, its part of the global.
 

mitchellde

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you would use a 99211 if a nurse removed the sutures. if a doctor sees the patient to remove them, then you can bill a higher level if documentation supports the level. there is no specific code for removing sutures.:)
FYI before your nurse can remove sutures put in by the ED physician, your physician will need to see and evaluate and write the order to remove the sutures. Your nurse is employed by your physician not the ED physician, the nurse can only follow orders written by their physician they are employed under.
 
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