Wiki Lacrimal Punctum, by Plug

[karriedemas@yahoo.com]

CPT Description states: 68761 - Closure of the lacrimal punctum, by plug, each.

Physician inserted 2 plugs, E2 and E4, LLL and RLL - We billed 68761 E4,E2 with 2 units in the quantity. Highmark Blue Shield is denying stating: Missing/incomplete/invalid days or units of service.

This doesn't make sense because we need to get paid for 2 plugs and the cpt does states "each". Please, I would appreciate any input on how I get this claim paid.

Thank you,
Karrie

 

[Rindahlnicole]

Modifier 50

This code is a unilateral code. Instead of using 2 units, try using modifier 50. This modifier makes it bilateral since a plug was put into each eye. Make sure you still keep the E4 and E2 on the claim as well.