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Thread: Ptergium removal

  1. #1

    Default Ptergium removal

    AAPC: Back to School
    Can anyone tell me the correct code for excision of ptergium?

    Also, is code 92226 used when it is subsequent to a 92225 on the same day? What if it is a different visit on a different day--then do you use 92225 again, or do you then bill a 92226?

    Thanks for any input!

  2. #2


    FOr Ptergium removal you would use 65420 without graft and 65426 with graft.

    As for billing an ophthalmoscopy: 92225 is use the first time you inqire about a disease, if performed bilateral-92225-RT and 92225 LT (or with a 50 modifier, depending on what your carrier prefers). Any time it is performed for the same condition on the patient on a different DOS, you would bill 92226.
    If the patient is seen for a new condition and an extended ophthalmoscopy is performed you could bill the initial 92225 again.
    adrianne, cpc

  3. #3


    Thanks so much for your help!

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