4 Options Take the Mystery Out Of Suture Removal Coding
Published on Sun Jun 04, 2006
Here's why 15850-15851 with modifier 52 is not an option Reporting suture removal procedures is tricky -- especially because you won't find many codes for this service. Follow these basic scenarios that will allow you to claim these services with confidence. Option 1: Honor the -Global- Concept If the same physician who placed the sutures removes them during the global period of the original procedure, you cannot report the removal separately.
Example: The patient underwent a laceration repair eight days ago for a 5-cm cut on her scalp. The original procedural code, 12032 (Layer closure of wounds of scalp, axillae, trunk and/or extremities [excluding hands and feet]; 2.6 cm to 7.5 cm), already includes the suture removal.
-Laceration repair codes (12001-13153) that would require a suture removal have a 10-day global period,- says Linda S. Templeton, CPC, coding consultant for The Rybar Group Inc. in Fenton, Mich. Therefore, if the patient comes in within that global period, you can't report the suture removal separately because it's already a part of the global service.
Other procedures that involve suture removal include major surgeries, which carry a 90-day global, Templeton says. -So for any other occasion, you wouldn't typically come across a scenario where you would consider reporting the suture removal separate from the primary procedure.-
Tip: You can't report it to your payer, but 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a post-operative period for a reason[s] related to the original procedure) is valid for covering suture removal and is good for tracking.
Although it has a zero charge, you can 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, Templeton says.
Option 2: Report 15850 or 15851 If you must place a patient under general anesthesia for suture removal, you may be able to report the service separately using 15850 (Removal of sutures under anesthesia [other than local], same surgeon) or 15851 (Removal of sutures under anesthesia [other than local], other surgeon).
Example: A patient received sutures for a serious wound, and skin has grown over the sutures, requiring a complex suture removal. The same surgeon who placed the sutures returns the patient to the OR and places her under general anesthesia to remove the sutures. In this case, you may report 15850.
Avoid this mistake: You shouldn't append 15850 or 15851 with modifier 52 (Reduced services) to get paid for suture removal without anesthesia.
-This doesn't work because the anesthesia is the main component of the code -- either you-re doing it under general anesthesia or you-re not really performing the procedure,- says Barbara J. Cobuzzi, CPC, [...]
