Effective January 1, 2011, Medicare eliminated the 10 day global period for simple wound repairs (CPT 12001-12018). Follow-up visits and suture removal charges should be assigned as appropriate.
FAQ 5. Can I bill for postoperative suture removals?
Suture removals are typical post op care and are bundled with the initial procedure assuming the "same physician" performed the procedure. For coding and billing purposes, physicians of the same specialty in the same group practice are considered to be the "same physician." Suture removals for simple lacertation repair are not bundled into procedure codes 12001-12018 for Medicare.
FAQ 6. Can I bill for follow up care and wound checks?
The wording in CPT bundles "typical post operative care" into a procedure. Most likely, "typical" will have to be defined on a case-by-case or group by group basis. Wound checks two days after an "I and D" or repair of a contaminated laceration may or may not represent "typical care" and low level E/Ms may still apply. Packing removals may represent "typical care", as the packing removal is an inherent and expected component of the original Incision and Drainage. Once again the "same physician" concept applies. Wound checks following simple wound repairs (CPT12001-12018) are separately billable beginning the day after the procedure for Medicare.
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