suture removal-does anyone

eadun2000

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If the doctor is the one that put the sutures in, then you dont code anything.. it will fall under global, unless you are outside of the global period. If you are outside the global period or the physician removing the sutures was not the same that put the sutures in, it is included in the E&M.
 

CVelez

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If you are billing for the facility you should look at codes 15850 -15851. Facility does not have same global period as physician.


Charla
 

mitchellde

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Those are for removal under anesthesia which must be more than local. If you are the facility billing facility charges you should have say points on your assesment tool to account for suture removal to give you a visit level.
If you are physician billing:
If you or any physician in your group put them in then it is global and non billiable to tremove them.
If you are a different physician in a different group that has had the patient transferred to you for the removal (Er notes to return to PCP for suture removal) and it is still in the global, then you bill using the same repair used by the surgeon and append a 55 modifier. Using the ICD-9 code og V58.32 and no laceration or wound code since the patient does not have a wound at this time.
 

MnTwins29

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Thank you - should have read this first!

Thank you Deborah! This answers a question I posted in the ER section here before I read this thread. One question for you - do you have any references that state the facility can charge a technical fee? I think Medicare Claims Manual is the place, but is that it? Thanks!:)
 

mitchellde

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I am not sure what you mean by technical fee. In the instruction for APC coding and billing it will tell you that there is no global for facility billing. If the patient comes to the facility whether it is clinic or ER the facility may assess the patient and apply their own unique assessment "tool" to determine the visit level. We developed a tool using points. if the points add up to a visit level then that is what is charged. So even though a physician may not charge for a return encounter within the surgical global, if that encounter occurs within the facility, then the facility may submit a visit level.
 

Jacoder

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In my 2011 CPT book it states that the global days are "000". Has it changed within the past year? And if so, these rules don't apply anymore, do they?
 

mitchellde

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Jennifer this is for physician global and again does not apply to facility. As of 2011 Most (not sure about all) lacreration repair codes have a 0 global period.
 
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