Global surgical service exclusions
Q: In the July/August 1999 issue [page 12], you recommended using an office visit code for in-office removal of sutures placed by another physician. Even if another doctor provided the original service, wouldn't suture removal be considered a part of the global surgical service and as such not be reimbursable to the physician removing the sutures since he would have no diagnosis to make this a separate, identifiable E/M service?
A: Suture removal is generally included in the global surgical package if the removal is done by the physician who performed the surgery. However, the global surgical package excludes services of other physicians and would therefore exclude suture removal in this case. Incidentally, there is a diagnosis code that covers suture removal: V58.3, "Attention to surgical dressings and sutures," includes change of dressings and removal of sutures.
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