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New to Ophthalmology . guidance needed w/cpt coding

louise Posted Thu 09th of April, 2020 15:00:08 PM
full thiectionckness res >2/3 eyelid full thickness reconstruction >2/3 with cutler beard flap from lower eyelid ATR for closure of eyelid defect Left conjunctivoplasty, Left conjunctival biopsy x 4
SuperCoder Answered Fri 10th of April, 2020 12:02:06 PM

Hi Louise,

For 2/3 eyelid full thickness reconstruction, CPT 67971 can be used with LT modifier. In this procedure, the provider everts the opposite upper or lower lid from the defect and makes an incision through the tarsus and conjunctiva. He advances a tarsoconjunctival flap to the defective eyelid and secures it in place with sutures.

For Left conjunctivoplasty, CPT 68326 can be coded with LT modifier. In this service, the provider removes a piece of conjunctival tissue to repair scarred conjunctiva or a shortened, or scarred, cul de sac of the eye that various conditions cause. The provider performs the surgery with the patient under a local anesthetic and appropriately prepped and draped. The provider begins by placing an ocular speculum in the patient's eye. Using an operating microscope, he removes conjunctiva from the underlying tissue and prepares the recipient location as necessary. He then prepares the graft and sutures the graft of conjunctival tissue into the lower cul de sac or the fornix as necessary to repair the conjunctiva. If the provider needs to reform the fornix, he may utilize either a cul de sac fixation suture to secure the site for the correction of the inadequate lower cul de sac or a stent, or tube, sutured to the orbital rim to mold the fornix.

Also, for conjunctival biopsy, CPT 68100 can be used, but only once. Because its MUE is one. Append the modifier LT. Code 68100 is a column 2 code for 68326, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.

Hope this helps!

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