Wiki Suture removal-I know that

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asonger

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I know that suture removals typically aren't paid by insurances, because of the global period. What if the sutures were not placed in our office? For instance, we are in close proximity to the local ED & we tend to get a lot of suture removals that the ED has placed. One of the other billers in the office stated to bill a office visit E/M (New or est. patient). At the state coding conference last week that was one of the topics from the speaker for the "E/M Auditing" session. She said that you are never able to "up-code" to get a suture removal paid for. Any suggestions or help on how correctly code this procedure?
Thanks!
 
In 2011 CMS decided that minor lac repairs would have 0 global from that point forward, most commercials have followed this. Therefore most suture removals for lac repairs are no longer global so use the V58.32 dx code with an Ov level to remove them. If the payer does assign greater than 0 global days then you must use the same lac repair code used in the ER and append the 55 modifier.
For ICD-10 CM the dx code will be the laceration code with a seventh character of D. the CPT side is the same.
 
In 2011 CMS decided that minor lac repairs would have 0 global from that point forward, most commercials have followed this. Therefore most suture removals for lac repairs are no longer global so use the V58.32 dx code with an Ov level to remove them. If the payer does assign greater than 0 global days then you must use the same lac repair code used in the ER and append the 55 modifier.
For ICD-10 CM the dx code will be the laceration code with a seventh character of D. the CPT side is the same.
 
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