Pediatric Coding Alert

Question: A 10-year-old patient reported to the office to have sutures removed from a superficial 1-centimeter laceration on his right arm. Our nurse removed the sutures, but we did not repair the wound; an emergency-room physician made the repair seven days earlier. Can I report the removal, or is it covered in the global package?

Missouri Subscriber


Answer: Since your pediatrician did not perform the repair, the 10-day global period does not apply. Report CPT 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician) for the suture removal.

If your pediatrician performs the initial repair, report only 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). The suture removal is covered by the 10-day global period for the procedure if the same doctor performs the repair and the removal.