# Stitches removal



## dballard2004 (Jun 2, 2008)

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.


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## heatherwinters (Jun 2, 2008)

*Stitches Removal*

[SIZE=+1]*http://www.aafp.org/fpm/991100fm/coding.html*[/SIZE]


[SIZE=+1][/SIZE]
[SIZE=+1]*Global surgical service 		exclusions*[/SIZE]
*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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## dballard2004 (Jun 2, 2008)

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?


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## heatherwinters (Jun 2, 2008)

*Suture Removal After Global Surgical Period*

*Please review the following Article Quote
*

*http://medicaleconomics.modernmedic...ng-Cues/ArticleStandard/Article/detail/397635*

*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.


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## dballard2004 (Jun 2, 2008)

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.


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## heatherwinters (Jun 2, 2008)

*No Problem*

No problem.  Happy to help


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