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Chalazion excision

  1. #1
    Default Chalazion excision
    Medical Coding Books
    I need some clarificaton on chalazion excisions.

    I have a patient that had 4 chalazions removed from three different lids. We are the ASC and this was done under general anesthesia so I'm looking at code 67808 and it does state multiple but review of custom coder states multiple from 'an' eyelid so I'm thinking there should be three codes of 67808 with modifiers attached to specify the appropriate lids.

    Our coding company states otherwise with only one 67808 and no modifier(s).

    Any input?

    Thanks.

  2. Default
    I would just say 67808 w/ no modifier. Per Encoder Pro "Regardless of # of lids or defects"

  3. #3
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    I agree with Jamie, this should be only coded once.

    I also checked the modifier crosswalk for this code and 50/RT/LT are not approved to be used for this code.
    Mary, CPC, CANPC, COSC

  4. #4
    Default
    No there aren't modifiers 50/RT/LT but it does have the E1, E2, E3 & E4 which stands for upper right lid, upper left lid, lower right lid & lower left lid. Since these modifiers are on the crosswalk it just makes me feel that the multiple lids scenario is correct.

    This also better for recording in relation to medical records.

    I'm still feeling like the multiple lids are correct.

  5. #5
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    Quote Originally Posted by tgutierrez View Post
    No there aren't modifiers 50/RT/LT but it does have the E1, E2, E3 & E4 which stands for upper right lid, upper left lid, lower right lid & lower left lid. Since these modifiers are on the crosswalk it just makes me feel that the multiple lids scenario is correct.

    This also better for recording in relation to medical records.

    I'm still feeling like the multiple lids are correct.
    I stand corrected---here is a CPT assist:

    CPT® Assistant Detail



    Article Detail


    Year: 1999

    Issue: September

    Pages: 10

    Title: Eye and Ocular Adnexa, 67800, 67805 (Q&A)

    Body: Coding Consultation

    Question

    A patient presented to my physician's office for removal of chalazions, one on the right upper eyelid and another on the left upper eyelid. Would it be appropriate to report code 67800 with the modifier -50, or would it be more appropriate to report code 67805?

    AMA Comment

    From a CPT coding perspective, the series of codes for excision of chalazion 67800-67808 are unilateral codes. Therefore, if two chalazion are excised, one from the right upper eyelid and one from the left upper eyelid, then it would be appropriate to report code 67800, Excision of chalazion; single, with the modifier -50 appended to indicate that a bilateral procedure was performed.

    CPT code 67805 is intended to report the instance when there are multiple chalazions excised from different lids. For example, CPT code 67805 would be reported when there are two chalazion excised from the upper eyelid and lower eyelid on the same eye.


    © 2005 American Medical Association
    Mary, CPC, CANPC, COSC

  6. #6
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    The coding clinic was in 1999 which was prior to the E1-E4 modifiers, so since that little invention I would use the E modifiers not the 50.

    Debra A. Mitchell, MSPH, CPC-H

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