Ophthalmology and Optometry Coding Alert

Question: One to two months after repairing a corneal-scleral laceration, we frequently return to the OR to remove the corneal sutures (we're pediatrics - we cannot remove in the office).
 
Is there a better code than 66999 (Unlisted procedure, anterior segment of eye) with modifier -78 (Return to the operating room for a related procedure during the postoperative period) for the removal? Should we still use the laceration as the ICD or use an aftercare code?

Alabama Subscriber

Answer: There is not a code in CPT for suture removal besides the unlisted-procedure code you are now using. If, in your example, the patient was insured by Medicare, rather than a different type of insurance, the removal would not be billable at all. 
 Medicare would consider it to be incidental to the OR exam rendered during the service. In regard to the diagnosis or ICD coding, V58.3 (Attention to surgical dressings and sutures; removal of sutures) would be appropriate.

 - Answers contributed by Raequell Duran, president of Practice Solutions in  Santa Barbara, Calif.; Dennis Sandoval, MD, Eye and Facial Surgery of New Mexico, Albuquerque; and John Bell, CEO, Maine Eye Care, Waterville.