Primary Care Coding Alert

Question: An ER physician placed sutures that our family physician later removed. The government plans denied my claim with S0630 and 15850. What am I doing wrong?Maryland SubscriberAnswer: Codes S0630 (Removal of sutures; by a physician other than the physician who originally closed the wound) and 15850 (Removal of sutures under anesthesia [other than local], same surgeon) both represent suture removal, so you shouldn't report both procedures together.Remember: The "S" codes meet the needs of the private sector. Medicare and, likely, most other government plans do not pay for "S" codes.Better option: If your physician simply removed sutures, your best option usually is a low-level E/M code. Options could include 99201 (Office or other outpatient visit for the evaluation and management of a new patient ...) or 99212 (Office or other outpatient visit for the evaluation and management of an established patient ...). Check your physician's documentation of time and [...]