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Billing E/M for Suture Removal After Biopsy

  1. Default Billing E/M for Suture Removal After Biopsy
    Clearnace Sale
    Biopsy Code 11100 has no global period. Patient comes back in 7-10 days for suture removal. Would you bill another E/M (low level) to discuss results, ect...?

  2. #2
    That would first depend on who is removing the sutures and who is discussing the pathology results with the patient. In my office we do not charge for suture removal after a biopsy even if we are discussing the results with the patient. Most patients believe that if your office put the sutures in then you should take them out without an additional charge.
    Susan Ward, CPC, COC, CPC-I, CEMC, CPCD, CPRC
    AAPC ICD-10 Expert Trainer

    A small act of kindness a day can make someone's day special

  3. #3
    Milwaukee WI
    Default Global period
    Okay ... I know you haven't billed for the suturing of the wound.

    But if you HAD ... the wound closure (even simple closure) has a 10-day global.

    No charge for the visit when you take out the sutures. (Unless you have to take the patient to the OR for removal under anesthesia.)

    F Tessa Bartels, CPC, CEMC

  4. Default
    To FTessaBartels and Susan: I am not talking about billing an E/M during a global period. The thread states "Biopsy".

    Sometimes the punch biopsy will require a suture. When the patients are coming back for suture removal and discussing results should we bill for an office visit.
    Some believe that it should be included, if so then why is there no global period. Does the charge for biopsy cover the next return visit to remove sutures, discuss test results and determine the treatment based on results? At the time of the return visit the physician still has to review results with patient, check site for healing and/or infection, remove suture and make decision for treatment.
    I know that patients get upset because they may have a second co-pay because of billing an E/M but do you believe the biopsy cpt code and payment covers the additional visit, time and evaluation of results that the physician has to put into it?
    If the physician does an excision and sends it to pathology, then there is a global period, patient comes back under post-op and the doctor usually gets paid twice as much for the excision and biopsy is included.

    I am just looking for other opinions on the matter. This is my thought. Any other thoughts would be appreciated....

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