Ophthalmology and Optometry Coding Alert
Multiple Xanthelasma Removal
Question: Our physician removed xanthelasma from all four lids. There was extensive muscle dissection the xanthelasma had invaded the underlying orbicularis muscle on all lids. Nasal fat was also removed. Should I use blepharoplasty codes? Arizona Subscriber Answer: For excision of the xanthelasma on the upper lids, report 11442 (Excision, other benign lesion [unless listed elsewhere], face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm) or 11443 ( lesion diameter 2.1 to 3.0 cm) depending on size, appended with -E1 (Upper left, eyelid) and -E3 (Upper right, eyelid). Then for the rotational flap reconstruction of the upper lids, use 14060 twice (Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less), once with modifier -E1 and once with modifier -E3. For the lower lids, report blepharoplasty code 15821 (Blepharoplasty, lower eyelid; with extensive herniated fat pad) with modifier -E2 (Lower left, eyelid) and 15821 with modifier -E4 (Lower right, eyelid). No code exists for dissection of the orbicularis muscle. The fat removal is bundled with the blepharoplasty.
Ophthalmology and Optometry Coding Alert
- Use Eyelid Modifiers (-E1, -E2, -E3, -E4) for Three Procedures
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CMS Announces OPT Not Covered for Occult Lesions
On March 28, 2002, CMS announced that ophthalmologists cannot use 67221 (Destruction of localized lesion [...] - You Be the Coder:
IOL Placement
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When you examine a glaucoma patient, some carriers limit additional diagnostic procedures. They may object [...] - Reader Question:
Bilateral GDX
Question: How should we bill for GDX testing when performed bilaterally? Ohio Subscriber
Answer: You [...] - Reader Question:
Prosthesis Implantation
Question: Our physician inserted a retinal prosthesis. How should I code this procedure? Florida Subscriber [...] - Reader Question:
Multiple Xanthelasma Removal
Question: Our physician removed xanthelasma from all four lids. There was extensive muscle dissection the [...] - Reader Question:
Diagnosis for New Eyeglasses
Question: When we prescribe new eyeglasses only, should we use a diagnosis of 368.8? What [...] - Reader Question:
Postsurgery Astigmatism
Question: How should I code surgically induced astigmatism? California Subscriber Answer: The correct ICD-9 code [...] - Reader Question:
Office Visit and Refraction
Question: A Medicare patient comes in for a medical examination, and we also perform a [...] - Reader Question:
No Foreign Body
Question: Which diagnosis code should we use when a patient comes in with a foreign-body [...] - Reader Question:
Levator Resection
Question: What is the code for a levator resection? New Jersey Subscriber Answer: For an [...]
