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SUTURE REMOVAL VS OFFICE VISIT

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Thread Topic: SUTURE REMOVAL VS OFFICE VISIT


Topic Originator: Donna
Post Date March 24, 2008 @ 2:04 PM
SUTURE REMOVAL VS OFFICE VISIT SUTURE REMOVAL VS OFFICE VISIT

SUTURE REMOVAL VS OFFICE VISIT

Donna
SUTURE REMOVAL VS OFFICE VISITMarch 24, 2008 @ 2:04 PM Reply  |  Email Friend   |  |Print  |  Top

I HAVE A PHYSICIAN THAT WANTS TO BILL A CHARGE FOR OFFICE VISIT AND TO HAVE SUTURES REMOVED, IS'NT THIS INCLUDED IN THE OFFICE VISIT?

Teena
SUTURE REMOVAL VS OFFICE VISITJanuary 29, 2009 @ 3:24 PM Reply  |  Email Friend   |  |Print  |  Top

Did the same doc put the sutures in?  If so he should bill for his services but normally the removal is bundled in suturing.
If your doc is only removing the sutures, he can bill for suture removal.

Hope this helps

steve verno
SUTURE REMOVAL VS OFFICE VISITJanuary 29, 2009 @ 6:17 PM Reply  |  Email Friend   |  |Print  |  Top

Scenario A:

patient goes to Dr. Jones on January 1, 2009 with an open wound.  Dr. Jones puts in 3 sutures on a minor wound. The patient returns to Dr. Jones on January 6, 2009 for suture removal. The removal would be considered as included within the Global period and not paid.

Scenario B:
patient goes to Dr. Jones on January 1, 2009 with an open wound  Dr. Jones puts in 3 suture for a minor wound.  The patient goes to see Dr. Jones on January 12, 2009.  The global period for the wound repair is 7 days.  Dr. jones has a choice as to bil for the removal.  This is because the removal is beyond the global period and could be billed and possibly paid.

Scenario C:
patient goes to Dr. Jones on January 1, 2009 with an open wound  Dr. Jones puts in 3 suture for a minor wound.  The patient goes to see Dr. Smith on January 7, 2009 to have the sutures removed,  The removal is within the lobal period but Dr. Smith didnt put the sutures in and could charge for the removal.  The insurance company could deny payment statin global period but this can be fought and won.

per cpt:

CPT Surgical Package Definition

The services provided by the physician to any patient by their very nature are variable. The CPT codes that represent a readily identifiable surgical procedure thereby include, on a procedure-by-procedure basis, a variety of services. In defining the specific services "included" in a given CPT surgical code, the following services are always included in addition to the operation per se:

    local infiltration, metacarpal/metatarsal/digital block or topical anesthesia;

    subsequent to the decision for surgery, one related E/M encounter on the date immediately prior to or on the date of procedure (including history and physical);

    immediate postoperative care, including dictating operative notes, talking with the family and other physicians;

    writing orders;

    evaluating the patient in the postanesthesia recovery area;

    typical postoperative follow-up care.

Kathy
SUTURE REMOVAL VS OFFICE VISITFebruary 3, 2009 @ 10:39 AM Reply  |  Email Friend   |  |Print  |  Top

The only CPT code for a suture removal is under general anesthesia.  Therefore, the request to bill and visit and suture removal is moot.
The suture removal, whether with local or no anesthetic is bundled into the office visit.
This also assumes that the removal is not by the same doctor, or, the removal was not done during the global period by the doctor who placed the sutures.

Linda Spray
SUTURE REMOVAL VS OFFICE VISITFebruary 12, 2009 @ 9:39 AM Reply  |  Email Friend   |  |Print  |  Top

We have used V58.32 when we've removed sutures another physician performed the surgery.



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