Vaida Posted Mon 16th of May, 2016 13:08:32 PM
Hi. I am confused about billing Incisional biopsy of eyelid skin and lid margin (CPT 67810) when this procedure is performed multiple times on the same date of service. I understand BILAT SURG indicator for this procedure is 1, which means 150% payment adjustment for Bilateral procedure applies. So if we perform one biopsy on the right eyelid and one on the left eyelid, we would bill 67810 at 1 unit with modifier 50. Is that correct?
But what if we perform this procedure on the right upper eyelid as well as right lower eyelid? Do we report CPT 67810 at two units or on two separate claim lines?
What if we perform 4 incisional biopsies of eyelid on the same day - on the right upper and lower eyelids as well as on the left upper and lower eyelids? Thank you in advance for your response.
SuperCoder Answered Tue 17th of May, 2016 05:30:27 AM
The CPT code 67810 for Incisional biopsy of eyelid skin and lid margin represents a unilateral procedure. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers. Modifier 50 identifies a procedure performed identically on the opposite side of the body (mirror image). If the provider performs different incisional biopsies of the eyelid on the same day, use the eyelid modifiers: -E1 for upper left, -E2 for lower left, -E3 for upper right, and -E4 for lower right.
Hope this helps!