Pediatric Coding Alert

Question: An established patient hit his forehead on his surfboard while on vacation in Hawaii; he had a 2.7cm laceration just above his left eyebrow sutured shut in a Hawaiian ED. He reported to the practice last week for suture removal. One of our nonphysician practitioners (NPPs) spent 4 minutes taking the sutures out. We reported 99211 with 873.42 appended and received a denial. Are we allowed to code for suture removal?

Michigan Subscriber

Answer: You can code for suture removal; you just chose the wrong diagnosis code. When you re-submit the claim, report the following:

• 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem[s] are minimal. Typically, 5 minutes or less are spent performing or supervising these services.) for the E/M
• V58.32 (Attention to dressings and sutures; encounter for removal of sutures) appended to 99211 to represent the suture removal.

Explanation: You must choose the V code over 873.42 (Other open wound of head; face, without mention of complication; forehead), as the laceration no longer exists when you remove the sutures.