Question: An established Medicare patient was seen in our primary care office for a follow-up from the Urgent Care to have sutures removed. Do we need to report modifier 25 on our E/M code with 15853 for the suture removal? The doctor also talked to the patient about their hypertension while they were there so they did not have to come back for another visit the next month. We want to report G2211 but we can’t if we have to put modifier 25 on the E/M.
Answer: Great question! CPT® code 15853, Removal of sutures or staples not requiring anesthesia, is a practice expense only code. There is no physician work or malpractice RVUs built into the code. When you check the NCCI edits, 15853 does not bundle with E/M codes, so modifier 25 would not be necessary on the E/M. Since there is no modifier 25 on the E/M, G2211 would also be able to be reported with this encounter if your practice meets the requirement for reporting it for this patient. Assuming the documentation supports an E/M (let’s use 99213) and suture removal, the codes that would be reported are:
99213, 15853, G2211. Hope that helps.
*NOTE: This response is current in January 2025. As guidelines and payor guidance may change, please be sure to check if it is still valid when you are reading this issue.
