I'm a little confused by the question, but I don't agree with 13160 since this was not a closure and there was no dehiscence. Is the patient status post silver nitrate for excision of vaginal granulation tissue and now physician is excising additional granulation tissue with scissors (silver nitrate for hemostasis)?
Vaginal granulation tissue is typically at the vaginal cuff (internal). There is no code exactly for that and sometimes is very basic removal, other times can be rather extensive. The AUGS recommendation is unlisted 58999, and I think I've seen that elsewhere as well.
https://www.augs.org/clinical-practice/archived-coding-questions/
What I have done is if it was very basic, and the doc just applied a little silver nitrate in 1 minute, I just bill the E/M.
If it needed to be more extensive, I then bill unlisted and ask it to be valued as 57105 or another similar code.