Ophthalmology and Optometry Coding Alert

Question: I have an op note that indicates the surgeon excised two chalazions from the patient’s right upper eyelid. The provider documented that the total excised diameter of the cysts was 0.7 cm. They are trying to report 11441 for the procedure, but I think we should assign 67801. What is the correct code to report?

South Carolina Subscriber

Answer: Use 67801 (Excision of chalazion; multiple, same lid) to report the multiple chalazion excisions. This code is designated for the procedure performed on more than one cyst on the same eyelid, which in this case is the right upper eyelid.

It is tempting to report 11441 (Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm) for the excision procedure, but this code is incorrect because 67801 specifically mentions the exact type of cyst that the provider removed.

In fact, the CPT^® code book includes several eyelid-specific excision codes that mention chalazions in the descriptors, such as:

• 67840 (Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure)
• 67800 (Excision of chalazion; single)
• 67808 (… under general anesthesia and/or requiring hospitalization, single or multiple).

Mike Shaughnessy, BA, CPC, Production Editor, AAPC