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CODES

Rana Posted Wed 04th of December, 2019 15:31:27 PM
WE HAVE NEW OCULOPLASTIC DOC AND I AM STRUGGLLING WITH CODES... I NEED TO BILL 15823 50 DX H02.831 H02.834, 67900 50 DX H57.813 (DO I PUT 51 ON THIS LINE), AND 67908 50 DX ? WITH MOD? ITS MEDICARE AND I KNOW THEY DONT LIKE 59 MODIFIER AND COULD PAY BUT MAYBE RECOUP IS THAT CORRECT. PLEASE HOW DO I BILL THESE 3 LINES
SuperCoder Answered Thu 05th of December, 2019 04:02:45 AM

Hi Rana,

 

As per NCCI edits for Q4 2019, CPT code 15823 (Repair of Blepharoplasty) gets bundled in CPT code 67908 (Repair of blepharoptosis), however an appropriate modifier (Modifier 59) should be appended with CPT code 15823 to bypass the bundling edit.

 

Your documentation should justify the need and medical necessity to perform both procedures together.

 

If your documentation is strong enough to bypass the bundling edit, you should bill in the below mentioned manner:

  • 67900 - 50
  • 15823 - 50, 59
  • 67908 - 50

 

Note: Use appropriate ICD-10 CM codes as per your documentation with CPT code 67908.

 

Thanks!

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