trose45116
Expert
does anyone know what code bill for when a doctor removes sutures.
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suture removal-does anyone
- Thread starter trose45116
- Start date
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.
mitchellde
True Blue
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.
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.
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!
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
True Blue
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.
mitchellde
True Blue
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.