Pediatric Coding Alert

Question: For suture removal, may I refer the patient to the facility that placed the stitches, or is it OK to bill the removal as a laceration?

Florida Subscriber

Answer: Usually, the pediatric office would code the suture removal with an office visit code (99201-99215, Office or other outpatient visit ...) and V58.32 (Encounter for removal of sutures). "Removal of sutures by other than the operating surgeon may be coded as a level of E/M service if the suture removal is the only postoperative service performed," according to CPT Assistant Spring 1992.

If payers deny V58.32, you could refer the patient to the emergency department. Do not, however, use a laceration code, such as 12001 (Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities [including hands and feet]; 2.5 cm or less), which would incorrectly indicate you repaired the wound.

Alternative: HCPCS does offer a suture removal code, S0630, Removal of sutures by a physician other than the physician who originally closed the wound. But you should check with payers before using this code, which contains no relative value units.