March 26, 2015

Question:
Our surgeon saw a patient in the ER for a fracture and reported the global fracture code. The ER physician had repaired a separate wound laceration at a different site prior to our surgeon arriving in the ER. The patient is now being seen in the office and the surgeon evaluated the wound area, and removed the sutures. Is this reportable? If yes, what CPT code would I use?

Answer:
Thanks for your inquiry. There is no CPT code for suture removal in the office, and the work associated with removing the sutures is inclusive to any reportable E&M service performed on the same day. In your example, the patient is in a global period for the fracture, thus E&M work associated with the fracture is not reportable. An E&M for evaluation of the separate stand-alone wound is reportable if medical necessity is present. As the patient is in a global period, the surgeon will append modifier 24 (unrelated E&M during the global) to the established patient visit code and link the diagnosis to the wound.