February 14, 2019
We had a patient come into our office to have their sutures removed from a hand laceration repaired by someone else. The patient was hurt while out of state on vacation and couldn’t have the sutures removed while away; the original provider performed a layered repair. The problem is the patient is still in the global period from the repair performed by another physician. How can I report this work? Is it not billable since the patient came into our office during the other physician’s global period?
Billing for suture removal depends on several factors. The intermediate and complex repair codes have a global period of 10 days for the surgeon/practice who performed the original repair. Your physician is not in the global period of the physician who performed the repair. Ideally, the physician who placed the sutures would have reported the intermediate repair code with modifier 54 (surgical care only) and transferred care to you so you would report the same surgical CPT code with modifier 55 (postoperative management only). But we know this rarely happens!
There isn’t a CPT code for suture removal in the office setting. There are codes to report removal of sutures under anesthesia (other than local) for either the same surgeon (CPT 15850) or other surgeon (15851). Therefore, your work is captured through the appropriate level of Evaluation and Management (E&M ) performed and documented
*This response is based on the best information available as of 2/14/19.