Free removal of stitches... in the ER

jeepgirl, LPN, NP · Oct 25, 2008

maybe they include it in the first ER charge if stitches are required. however, i don't think it is ethical to charge for services not already rendered. so i don't know!

BrnEyedGirl, BSN, MSN, RN, APRN · Oct 25, 2008

We consider it a continuation of care. We put them in, they need to come out to "complete" the care. We don't charge for the removal IF we put them in.

racing-mom4, BSN, RN · Oct 25, 2008

We dont charge in our ER either.

FYI my vet doesnt charge either...Mabel was spayed at the Animal Control Center and the vet just met me in his waitng room and snip snip snip clipped them out..no office charge.

Come to think of it, sometimes our ER does kind of remind me of my vets office.

doc2bmo · Oct 25, 2008

We remove them because it's quick and easy and much better than having the patients do it themselves because they don't want to pay another fee. It takes about 1 minute and we can do it right in triage...in and out. I'd much rather do a quick suture removal than do a full triage assessment on a patient who is here because their shoulder has been sore for fourteen years (true story).....Hope your friend's pumpkin turned out good!

Happy Saturday to all!

:nuke:

noc4senuf · Oct 25, 2008

I have 4 kids and most of them have had stitches at one time or another. I have always removed them myself.... saves me a trip. I have also done it on two different dogs.

HeartsOpenWide, RN · Oct 25, 2008

emtrachel said:
OK, someone help me understand the logic of this...
A friend of mine had a pumpkin carving mishap that resulted in a visit to her local ER for stitches. She was told to return there in two weeks for them to be removed. They told her it would be free to have them removed in the ER. When she called her PCP office, they told her that they would have to charge her if she came there, but it was no cost if she returned to that ER.
Here's my question... why would an ER encourage non-emergent routine visits like suture removal to go to the ER? A PCP office can easily remove sutures, and provide any follow-up assessment/ care. Is there something I'm not considering?

Probably because the charge to remove the sutures is included in the application of the sutures...at least this is how it was done in the office I worked at. Sure the office can do follow-up care, but not for free...I could see that if the patient when to a PCP for an ER follow-up they could removed the sutures and include that in the office visit charge for the ER follow-up...but they are not going to just remove sutures for free....most of the time this requires an office visit; I removed sutures as a CMA after the doctor looked at the wound to make sure it was healed and ready for the sutures to come out...

mom2michael, MSN, RN, NP · Oct 25, 2008

In all the ER's I worked in (3 total) we always removed the sutures, free of charge, in the triage room. We would have the doctor look at the site on a as needed basis. I'm not a billing expert, but I understood it to be in the bundled billing charge for the suture placement.

vampiregirl, BSN, RN · Oct 26, 2008

I didn't realize that this is something that could be done in triage. The way it was explained to me, it sounded like the person was checked in, called back to a room (thus taking us an ER bed), waited for the doc to assess, then the stitches were removed.

I'm glad I asked this question, now that I have an answer, it actually does sense to me! Both the continuation of care and the billing issues (fees included in the first visit) make sense. Thanks!

vampiregirl, BSN, RN · Oct 26, 2008

doc2bmo said:
Hope your friend's pumpkin turned out good!
:nuke:

You know, when I asked my friend how the pumpkin was (when she told me she was going to the ER), I didn't exactly get an answer.:)

rjflyn, ASN, RN · Oct 26, 2008

My experience has been generally most places I have worked we take them out in triage unless it is a complex issue. Typically we dont charge the patient another visit unless they have a complication the requires further MD evaluation. If the doctor sees them again they typically they incur just that fee. Or if we have to use excessive supplies.

Rj

jeepgirl, LPN, NP · Oct 26, 2008

that sounds great! i wish more places did this... you don't know how many people i see walking around in walmart with nasty stitches. i remember i sat behind a girl in my stats class one year that got stitches and didn't get them removed for months - and the skin had grown over them. and when she did get them removed, she had a big nasty gash on her ankle. if she had just gotten them taken out when she needed too, it wouldn't have been so ugly!