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Stitches removal

  1. #1
    Overland Park, KS
    Default Stitches removal
    Medical Coding Books
    Please confirm something for me regarding stitches removal. If the physician repairs a laceration in the office with stitches and the patient returns to the office to have the stiches removed, the physician can not charge to have the stiches removed. Is this correct? Even if it is after the global period?

    If the stitches were put in by the hospital, but the patient's PCP takes them out in the office, the physician can charge for this, correct?

    Can anyone point me to the CMS guidelines that state this? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  2. #2
    Default Stitches Removal

    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.
    Heather Winters, CPC, CFPC

  3. #3
    Overland Park, KS
    Thanks for the help. Please clarify one thing more thing. If the physician put the stitches in, and they are removed after the global period, we still can't charge for this, correct?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  4. #4
    Default Suture Removal After Global Surgical Period
    Please review the following Article Quote


    Use an appropriate E&M
    What if you sutured the patient and then removed the sutures after the procedure's global period? In that case, you can incorporate the suture removal into an E&M visit. You'd code the same way if you aren't the doctor who originally sutured the patient.
    Heather Winters, CPC, CFPC

  5. #5
    Overland Park, KS
    Perfect! Thanks so much! I have to do a conference call with one of my clinics this week on this very topic and I wanted make very sure I had everything correct. Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow

  6. #6
    Default No Problem
    No problem. Happy to help
    Heather Winters, CPC, CFPC

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