# Suture Removal as a Tech Charge



## kukleja (Feb 16, 2010)

I have a question about suture removal and my MOHS Surgeon. We are being told in the office/outpatient setting even if my surgeon does the surgery - the nursing staff can bill a tech only E&M fee for the suture removal - 99211-99213 - Please advise - I was under the opinion, we put it in, we take it out as a bundled charge. Any thoughts or documentation stating this is or is not appropriate. Thank

ksu52@wowway.com


----------



## eadun2000 (Feb 16, 2010)

If memory serves, Moh's is a 90 day global and the suture removal definately falls in the 90 day period, so no you cannot charge a nurse visit 99211 with that suture removal. It is bundled with the procedure.


----------



## Susan (Feb 16, 2010)

kukleja said:


> I have a question about suture removal and my MOHS Surgeon. We are being told in the office/outpatient setting even if my surgeon does the surgery - the nursing staff can bill a tech only E&M fee for the suture removal - 99211-99213 - Please advise - I was under the opinion, we put it in, we take it out as a bundled charge. Any thoughts or documentation stating this is or is not appropriate. Thank
> 
> ksu52@wowway.com



First may I start by saying because there are no global days associated with the MOHS procedure you could in fact bill for suture removal, but I honestly don't know many offices that will do that because the patient could become upset that you are charging them for the removal of something your office put in.  Even further if you office does have your nurses removing the sutures then the only E&M code available to my understanding would be 99211.   The supporting documentation would fall within the global days assigned to the procedure on actually billing for the removal.


----------



## kukleja (Feb 19, 2010)

*MOHS Surgery and Suture Removal*

First let me thank both of you for your responses - Pointing out that there are no global days on the MOHS surgery but on the closure is pertinent to this conversation - the physician keeps telling me there is a 90 global day on the surgery - (I got confirmation from CodeCorrect.com to show to her)
The global period is on the closure (from Code Correct) can help me discuss this with her - 

Secondly, I believe for the purposes of this conversation that the nursing time to remove the sutures (facility charge only) is for our idea overall on the time nursing spends with patients performing services that do not require a physician. We have been advised by a consulting firm for the outpatient/office setting that we should be charging the 99211 for the suture removal and I was looking for other feedback - I always thought we put it in, we should take it out. I will be interested to see if insurance carriers will pay this as a facility charge. 

Thank you both - I appreciate the conversations and thoughts.


----------

