General Surgery Coding Alert

Question: May we report suture removal separately? California Subscriber Answer: You may be able to report suture removal separately, but only in relatively rare circumstances. If the same physician who placed the sutures removes them during the original procedure's global period, you cannot report the removal separately. So, for instance, if a patient returns to the office for suture removal six weeks after a major surgery (that is, any surgery with a 90-day global period), you cannot report the removal separately (it's part of the standard follow-up care). Tip: 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) has a zero charge, but you can use it 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. 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) -- but cases that call for coding of this kind are unusual. - 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.