Pediatric Coding Alert

Question: A patient came to our practice for suture removal. Our group did not perform the surgery. Can we charge the E/M visit using modifier 24 since we are taking over the patient's care?

Virginia Subscriber

Answer: When another physician, who is not an associate or partner of your pediatrician, performed the surgery, you should bill an E/M service for the suture removal. You do not need modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period) because your pediatrician/group is not involved in the other physician's global period.

Code the suture removal as part of an office visit (99201-99215, Office or other outpatient visit ...) including ICD-9 code V58.32 (Encounter for removal of sutures). "Removal of sutures by other than the operating surgeon may be coded as a level of E/M service if the suture removal is the only postoperative service performed," according to the Spring 1992 CPT Assistant.

Alternative: HCPCS offers a suture removal code, S0630 (Removal of sutures by a physician other than the physician who originally closed the wound). But you should check with payers before using this code, which contains no relative value units and is not recognized by Medicare and several other carriers.