AHA Coding Clinic® for HCPCS - 2025 Issue 3; Ask the Editor

Reporting CPT Codes 15853 and 15854

According to the guidance in the July 2023 CPT Assistant, Pages 14-15, add-on codes 15853, Removal of sutures or staples not requiring anesthesia (List separately in addition to E/M code), and 15854, Removal of sutures and staples not requiring anesthesia (List separately in addition to E/M code), are intended for practice expense (PE) reporting and must be listed separately in addition to an evaluation and management (E/M) service. The guidance further specifies that, for non-facility reporting, these codes may only be reported in conjunction with E/M office visit codes. However, we see these codes being reported in the emergency department (ED) in conjunction with ED E/M codes 99281-99285. Additionally, the parenthetical notes following codes 15853 and 15854 include the ED visit codes, implying that such reporting is allowable.This raises a key question: If codes 15853 and 15854 are for non-facility reporting only, why do the parenthetical notes indicate that ED E/M codes are reportable with them? Does this mean that these codes are also appropriate for facility-based (eg, hospital ED) reporting? ...

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