In 2010 Medicare stated that minor laceration repairs have a 0 global day, many private payers have followed this rationale. Therefore if the ER repairs a laceration and your office is removing the sutures, you use a low level office visit for your physician to evaluate the patient and remove the sutures. No modifier is needed and you do not use the Z code for suture removal, you use the laceration code with 7th character D.
Also this cannot be a nurse only encounter. The physician she is employed with must first evaluate the patient and write the order for the removal.
On the other hand if it's an established patient and the sutures were placed by an office physician as part of a procedure and wants the patient to come in for suture removal in X number of days, it
can be a low-level nurse visit... as
long as there is no global period in effect, or the global period has expired. There may be some scenarios where sutures are placed with a procedure that has 0 postop days.
In most cases if the sutures were part of a procedure and you are still inside the global period (10 or 90 days), when the sutures are being removed, you cannot charge for it.
