Wiki Bleph/ with Ptosis Repar

Create Wiki
H

hmccullough100@gmail.com

Contributor
Messages
17
Location
Greensburg, Pennsylvania
Best answers
0
I have a physician who does Upper Eye Ptosis repairs along with functional Blepharoplasties. I believe you can only get paid on one of these even with a 59 modifier. Anyone have thoughts on this? Thank you for any input you might have.
 
I'm confused. What type of 'repair' are you coding? A ptosis repair is generally coded as a blepharoplasty. If you are coding the repair from the 12xxx or 13xxx section of CPT, you are unbundling. You can check for sure by looking at the CCI edits.
 
He actually does cpt code 67904 along with 15823 but according to cci edits they will only pay the one code. This has confused me and on another thread I read they both can be billed with a 51 modifier on one. However, if you use encoder it shows them not being able to be billed together.... Hope that explains my dilemma....
 
NCCI Edit Results:
Edit exists with 67904. 15823 is a Column 2 code. If both 67904 and 15823 are submitted, only 67904 will be paid.
- This edit CAN be overridden via CCI-associated modifiers WHEN APPROPRIATE.
- Rationale: Mutually exclusive procedures
- Effective 4/1/2009

The only way you'd be able to report both is if they were on separate eyelids.
 
You must log in or register to reply here.
Top