Practice Management Alert

Question: Is suture removal considered part of an office visit charge, or can it be billed separately?
 
Michigan Subscriber  Answer: You'll most likely run into trouble if you try to bill separately for suture removal. "Suture removal is bundled into the global surgical package when it's done by the same surgeon" who put them there in the first place, says consultant Catherine Brink, CMM, CPC, president of HealthCare Resource Management Inc. in Spring Lake, NJ.
 
If the sutures are removed by someone other than the original surgeon, then the removal is part of the evaluation and management, and is bundled into the office visit, Brink continues. Generally, E/M visits with suture removals are problem-focused and meet the requirements for a level-two visit. "If the visit and suture removal is more complicated and requires the physician to perform a detailed history, exam and medical decision making, then it's possible that it could go to a level three," she postulates. Further, there is no CPT code for general suture removal, she continues. "Therefore, you really can't code a suture removal."