You cannot add a 59 to an E&M level. and if the surgeon did not request that your PA remove them then you cannot bill for it because the surgeon is being paid via the global reimbursement to provide all post op care which includes the removal of sutures when done in the global. If the surgeon does transfer the post op care to you (in writing) then you can bill using the surgical code with the 55 modifier if this is still in the global. If the global has expired and the sutures need removal then you use the E&M code with no modifier.
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