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Code to remove sutures ???

  1. #1
    Salt Lake North
    Cool Code to remove sutures ???
    Medical Coding Books
    Here it is. Patient has operation and the surgeon closes the wound. Patient comes to our clinic, and has our doc removes 9 sutures. The only suture removal that I am seeing in the CPT is for when the sutures are removed under anesthesia. How do I code this when the patient gets the sutures removed not under anesthesia. And no, my doc was not the surgeon. Thanks for your ideas !!

  2. #2
    You would use an E&M level if the MD did not place the suture in
    Because your MD is that is not part on the global surgical package
    hope this helps
    Robin Ingalls-Fitzgerald CCS, CPC, FCS, CEMC, CEDC

  3. #3
    S0630 Removal of sutures; by a physician other than the physician who originally closed the wound

    This is a non-Medicare code.

    Laura, CPC

  4. #4
    Charlottesville - Piedmont Association of Coders
    Along with your E/M -25 (modifier), Look at this CPT:

    97602 Removal of devitalized tissue from wound(s), non-selective debridement, without anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session

    Take Care...

    DeTeasa Brown, CPC
    Coding & Reimbursement Specialist
    Dept of Surgery

  5. #5
    Columbia, MO
    You can either use the S0630, or if the payer does not like that code then, if the patient is still in the surgical global:
    1. you must have a transfer of care authorization form the surgeon to remove the sutures and this must be in the patient's medical record, discharg instructions which direct the patient to return to PCP for suture removal works or a verbal order notation in the medical record works.
    2. A transfer of care note must be in box 19 of the CMS 1500
    3. Your dx code should be the V58.32; do NOT code a laceration code or a wound code
    4. You will use the same surgical code used by the surgeon and append the 55 modifier.

    Only use an E&M if the patient is outside the global. If you cannot ontain authorization to remove the sutures then send the patient back to the surgeon. I know many were not taught and it is a lot of work for very little reimbursement but it is the correct way. Also it is important to remember that your nurse or MA may not remove another physician's sutures. Your physician must see and evaluate the patient first then order the nurse to remove the sutures.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    what if a doctor of the same specialty(pediatrics) removes the sutures? Same clinic-same tax ID-different doctor?

  7. #7
    Greeley, Colorado
    Quote Originally Posted by efuhrmann View Post
    what if a doctor of the same specialty(pediatrics) removes the sutures? Same clinic-same tax ID-different doctor?
    Different physician in the same practice of the same specialty is considered to be the same physician. So it would be a no charge visit if still in global.
    Lisa Bledsoe, CPC, CPMA

  8. Default
    thanks Lisa!

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