HCPCS Code for Suture Removal

Question: I was just reading the Physicians Practice April 2010 Coding Questions. I really like this article each month, I always learn something.

I don’t totally agree with your answer to the question in regards to a code for suture removal. Your first sentence, “There is no code for suture removal,” is incorrect.

There is a HCPCS code for this: We use it whenever a patient presents with sutures put in by another provider, ER or Urgent Care, or a surgery. It is S0630 Removal of sutures by a physician other than the physician who originally closed the wound (not valid for Medicare). We have no problem getting our managed care payers to pay this code. If there is also an E&M billed, I would put a modifier 25 on the E&M and modifier 59 I on the S0630.

-Cynthia Szuch, practice manager
Carrboro, N.C.

Answer: Excellent! I never saw that code before - has it been around awhile? I'll look through some of my past HCPCS books. I’ve been talking to folks about this issue for years and this is the first time that this code has come to my attention - great find. I wonder how long I’ve had this wrong! Also, great feedback on getting commercial payers to pay using the code.

Bill Dacey, CPC, MBA, MHA, is principal in the Dacey Group, a consulting firm dedicated to coding, billing, documentation, and compliance concerns. Dacey is a PMCC-certified instructor and has been active in physician training for more than 20 years. He can be reached at billdacey@msn.com or physicianspractice@cmpmedica.com.

This question originally appeared in the June 2010 issue of Physicians Practice.