Add-on codes 15853 and 15854 were established to address practice expenses (PE) associated suture and staple removal procedures when performed in conjunction with an Evaluation and Management (E/M) visit. Here’s a breakdown of how to use these codes effectively:

When to Use 15853 and 15854

1. Setting: These codes only apply to non-facility settings such as offices or homes. They are intended for reporting (PE)-only (ie, clinical staff time, disposable supplies, use of equipment) and do not have physician work relative value units (RVUs) assigned to them.
2. Global Period: They are intended for procedures with a 0-day global period or possibly those with an XXX global period (e.g., anterior abdominal hernia repair). Suture removal is inherent to and included in the practice expense for all 10-day global codes (during and beyond the global period).
3. Add-on Code: Report 15853 or 15854 in conjunction with applicable E/M codes, such as 99202–99215, 99281–99285, and others. Modifier 25 is not required on the E/M code.

Key Differences Between 15853 and 15854

• 15853: For removal of sutures or staples (one or the other).
• 15854: For removal of both sutures and staples. These two codes cannot be reported together for the same session.

Special Considerations

• Anesthesia: For suture or staple removal requiring anesthesia, use 15851 instead. This code involves “general anesthesia” or “moderate sedation.”
• Multiple Uses: Codes 15853 and 15854 may be reported multiple times but only once per day.

Example Scenario

A patient returns 14 days after a lesion removal with code 11403 (10-day global period) for suture removal. Since the suture removal falls outside the global period, can you report 15853? No. Postoperative suture removal for 10-day global procedures is inherent to the original service and not separately billable, even beyond the global period.

References: CPT Assistant July 2023, May 2023 & March 2023.

​

Looking for additional information on this topic?