EM Coding Alert

Question: One of the doctors in our group saw a new patient in the emergency room for a dog bite. She sutured lacerations of the face. The patient came to our office one week later to see another of our doctors who removed the sutures. The second provider documented a 99213; however, shouldn’t this be a postop visit? 

Minnesota Subscriber

Answer: You cannot report suture removal if your physician was the operating physician who placed the sutures. Additionally, even if the second provider that did the suture removal is not the operating provider but both are in the same group/same specialty, the service is bundled into the procedure reimbursement and you cannot separately report the suture removal. 

While you will not get paid for the suture removal, you could use code 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure) for your practice’s own tracking. 

Tip: Many payers don’t recognize the code, but 99024 is valid for tracking. Although it has a zero charge, it’s always a good idea to use 99024 to keep track of visits for risk management purposes to show that the patient did present for a follow-up visit within the surgical period. Keep in mind that each surgical code requires the surgeon to see the patient for all appropriate visits during the post-operative period. By using the 99024, you clearly illustrate this.