Pediatric Coding Alert

Question: When a physician at another facility, such as the emergency room, places sutures and our pediatrician removes them, we charge an E/M code (99213). Should we also charge for a surgical tray (A4550) for the instruments used in the suture removal?

Oregon Subscriber

Answer: In an office setting, you should report both codes 99213 (Office or outpatient visit for the evaluation and management of an established patient) for the office visit and A4550 (Surgical trays) for the supply. Whether the payer will reimburse for the tray is another matter. Some managed-care organizations consider A4550 unnecessary and bundle it into the E/M code.

Answers to You Be the Coder and Reader Questions provided by Barbara Cobuzzi, CPC, CPC-H, CHBME, president of Cash Flow Solutions, a physician reimbursement company in Lakewood, N.J.; and Richard Lander, MD, FAAP, a pediatrician with Essex-Morris Pediatric Group in Livingston, N.J.