# Billing for an MA



## easumma (Jul 3, 2012)

If a patient comes in and the Medical Assistant removes stitches or looks at a wound can we bill for that and if so would we use 99211?


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## mitchellde (Jul 3, 2012)

If your physician is the original physician for this wound that repaired or dressed it then no it is global, if you are following up from an ER visit then no, not until your physician has evaluated the patient face to face and has a plan of care for the MA to follow for wound care or suture removal.  Your MA cannot follow up from a physician they are not currently employed with and working under.


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## easumma (Jul 3, 2012)

*99211*

It is for in the office. Yes if our doctor did for example hernia surgery and the patient ame in and our Medical assistant removed the stitches, can we use 99211? Or since she is just an MA can we bill for her?


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## shenikpinder (Jul 3, 2012)

*Suture removal*

The fact that she is a Medical Assistant has nothing to do with why she can not bill for what she is doing.  Medical Assistants can remove sutures, however, the fact that suture removals are included in the "global surgical package" makes it noncompliant with coding and billing guidelines to bill for the suture removal.

However, if you were removing sutures placed by another provider, (not of the same practice), then you could definitely bill a 99211.

Some helpful documentation:

http://www.aafp.org/fpm/2000/0300/p21.html#fpm20000300p21-sa3

Hope this helps.


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## mitchellde (Jul 3, 2012)

shenikpinder said:


> The fact that she is a Medical Assistant has nothing to do with why she can not bill for what she is doing.  Medical Assistants can remove sutures, however, the fact that suture removals are included in the "global surgical package" makes it noncompliant with coding and billing guidelines to bill for the suture removal.
> 
> However, if you were removing sutures placed by another provider, (not of the same practice), then you could definitely bill a 99211.
> 
> ...


Yes she could use the 99211 if performed by a different provider with many qualifiers
first you cannot use a 99211 and bill under your physician if your physician has not seen this patient previously for this issue and has ordered the suture removal
second if this is still in a different physician global then no you cannot use an office visit as it is already a different providers global you must have a physician encounter and bill the same surgery used by the referring physician with a 55 modifier.  If the surgeon did not referr the patient to you for post op care then you should send them back to their surgeon.
So  the only time you can use a 99211 for suture removal is if :
* your surgeon performed the surgery and it has no global
* a different physician performs the surgery with no global and your physician sees the patient and has them return for suture removal.


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