The Removal of Sutures

Medical billing allows for very little wiggle room in your descriptions and documentation. Almost all surgeries, whether performed in the doctor’s office, or in the operating room have a follow-up period. This means that during that particular 15-day, 30-day, 60-day, etc. period, any treatment the surgeon does for that surgery is included in the medical billing of the surgery itself. However, there is an exception to this rule.

An example of an exception to this medical billing rule deals with mentally handicapped patients. The removal of sutures is usually a procedure performed within the postoperative follow-up period. Medical billing is usually done only for the surgery. However, if a mentally handicapped patient needs to be put under general anesthesia and have his/her sutures removed in the operating room that is a different story.

If the same surgeon removes the sutures that did the original surgery, you would report the medical billing code 15850 (Removal of sutures under anesthesia, same surgeon). If a different surgeon takes the sutures out that put them in, report the medical billing code 15851 (Removal of sutures under anesthesia, other surgeon).

In medical billing, your only hope to get this exception paid for is to have adequate documentation. This documentation should be included with the medical billing and should explain why the patient needed general anesthesia for suture removal. As long as you stick to medically necessary procedures, you medical billing reimbursement should always reflect services provided and that along with strong documentation should enable you to see the reimbursements for the services that have been provided.

View all Articles by: Melissa Clark, CCS-P