Pediatric Coding Alert

Question: For suture removal, we found 15851. When a pediatrician removes sutures in the office and did not place them, could we use this code with modifier 52?


New Jersey Subscriber

Answer: Unfortunately, you cannot. You should use modifiers when a code does not tell a service's or procedure's full story. But you must provide that code's basic description. Code 15851 (Removal of sutures under anesthesia [other than local], other surgeon) is for suture removal under general anesthesia. Using that code for removal without anesthesia in the office is not the intent of that code. Attaching modifier 52 (Reduced services) to indicate a reduced portion of that code is inappropriate.

Better methods: Use an E/M code (99201-99215, Office or other outpatient visit ...) or S0630 (Removal of sutures by a physician other than the physician who originally closed the wound). For the ICD-9 code, report V58.32 (Encounter for removal of sutures).

Important: You indicate the pediatrician did not place the sutures. Therefore, your office may charge for the removal with an E/M service code or the HCPCS suture removal code. But if your practice does perform the laceration repair, the removal is included in the repair's 90-day global period. So you would instead code the postoperative care with 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure) and enter a $0 charge.