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suture removal-I need help

  1. #11
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    Exam Training Packages
    I just goggled this same question and find this on another forum. I'll post it all.

    ER coding question

    If a patient has a procedure done in the ER (such as I & D ) that has a 10 day global, if the patient returns within the 10 days do i bill 99281 or 99024 ? or is 99024 only for major surgery


    It depends. Why is the patient returning to the ER?


    What type provider is doing the procedure?

    If it is an ER Specialist, the Global concept does not apply. By the nature of their scope of practice an ER provider/specialist does not provide follow-up care. Follow-up care is part of the Global package and in order to bill "Global" you need to provide all the services included.

    If the provider is not an ER provider, you may bill the Global code. 99024 would be appropriate for usual follow-up care. Exceptions would be if patient presents with a new, unrelated problem...then you could bill an established patient visit (E/M) with 24 modifier attached. If patient is a Medicare patient, you'll need to check your carrier's policy as Medicare has additional rules about what's included in a Global and what constitutes a "new problem" or complication unrelated.

    99024 is for related, usual, post-op visits within any Global period. This applies to the provider, or member of their same group and specialty, who provided the original service.

    its an ER provider for a hospital, that patient is told to return within 10 days for packing removal and follow up, just like a laceration repair, the patient is told to return with 10 for suture removal, i know that if the provider did the procedure that the follow up is including if they return within the globel days, but because it is an ER setting i bill 99281 for suture removal or checking of an abscess


    If the provider is the same one (or member of same specialty,same group) who placed the sutures, he/she may not bill separately for removing them. The fee paid for placing the sutures includes remvoval of them.

  2. #12
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    Is the statement true that an ER physician cannot provide follow up care ?

  3. #13
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    VJ,

    Here is the update from ACEP facility guideline on Suture removal - "Wound recheck, Simple suture removal, return note for work/school would be coded with level 1 - 99281"

    Hope this helps you,

    And thanks for that statement, however I have very minimal knowledge over Hindi (thoda thoda maalum hai)

    Thank You and have a great day!

    Purnima S, CPC

  4. #14
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    So the facility may charge a 99281 but the physician cannot ?

  5. #15
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    Columbia, MO
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    12,557
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    Quote Originally Posted by cpccoder2008 View Post
    So the facility may charge a 99281 but the physician cannot ?
    The facility may charge a level even though the physician cannot is a true statement!

    Debra A. Mitchell, MSPH, CPC-H

  6. #16
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    International Member
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    Hey,

    Thank you very much to all of you for your valuable help!

    VJ.

  7. #17
    Default Suture removal
    Hi Vj,

    I am working for physician , We are using 99024 for patient who comes to ED for recheck with out any complications.
    I think you all know that 99024 is a "0" payment procedure, so we can use 99024 for suture removal in the CPT column.

    Regards
    SAMSON

  8. #18
    Default Different physician in ER removing sutures than the physician who placed them in ER
    I fully understand everything that has been previously mentioned, I however, have one more thing that I need clarification on... The patient returns to the ER (within the 10 day global) for the suture removal, a DIFFERENT physician removes the sutures than who placed them. Is this still not chargeable when this happens or is it still global? I understand if it falls outside the 10 day global that it's billable. Just confused if it's a different physician but same facility. Any feedback is appreciated!!!

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