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BILLING MANAGER

Rana Posted Wed 27th of March, 2019 13:02:26 PM
I NEED TO BILL 67840 RLL X 1 LINES AND 67840 LLL X 2 LINES ALL BILATERAL THEIR WERE 3 SEPERATE LESIONS SO MODIFIER 57 IS USED AS WELL AS 50 FOR BILATERAL, BUT I DONT KNOW HOW TO BILL 1 ON RLL AND 2 ON LLL . THANKS
SuperCoder Answered Thu 28th of March, 2019 03:59:03 AM

Thank you for your Question.

If you’re reporting CPT code 67840 for multiple lesions that are located on both lids, you should report 67840 with modifier 50 (Bilateral procedure) to indicate bilateral excision of lesions. As per the above provided documentation it seems the procedure was performed on RLL and LLL. Hence, the CPT codes would be billable as 67840-E4 &67840-E2.

But if you’re reporting a 11440-11446 code for multiple lesions on either the same or different eyelids, you should report the code for each lesion excised. You cannot add up the lesions to arrive at a larger size. For example, if your ophthalmologist removes two lesions, both under 0.5 cm in diameter, you cannot code 11441 simply by adding the sizes together. Instead, you should report the procedures on separate lines using 11440 twice with the appropriate modifiers as modifier 51 (Multiple procedures) or the eyelid modifiers (E1 for upper left, E2 for lower left, E3 for upper right, and E4 for lower right).

Note: Check with your payers to find out which modifiers they require when billing multiple lesion excisions. You will likely need to use either modifier 51 (Multiple procedures) or the eyelid modifiers (E1 for upper left, E2 for lower left, E3 for upper right, and E4 for lower right). Some payers will even want both modifier 51 and the eye modifiers.

 

Hope this Helps!

SuperCoder Answered Fri 29th of March, 2019 02:18:29 AM

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