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Second opinion on codes

louise Posted Mon 22nd of June, 2020 19:57:09 PM
Right lower eyelid ectropion repair 67917 . Right upper eyelid full thickness wedge resection 1/3 eyelid margin ? 67961 . Right conjunctivoplasty with rearrangement 68326 or 68320 . Right lateral tarsorrhaphy 67875
SuperCoder Answered Tue 23rd of June, 2020 11:13:44 AM

Hi,

Thanks for the question.

As per the limited documentation available it appears the codes can be appended. Code 68320 is an additional code. Therefore, the requirement of this code is not clear with the above documentation.

Also, as per the NCCI edits:

Code 68326 is a column 2 code for 67917, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.
CCI Edit Rule:
Misuse of column two code with column one code

Code 67961 is a column 2 code for 67917, but you may use a CCI-associated modifier to override the edit under appropriate circumstances.
CCI Edit Rule:
Mutually exclusive procedures

Hope this helps.

Thanks.

louise Posted Tue 23rd of June, 2020 13:06:13 PM
A lateral canthotomy and superior and inferior cantholysis was performed . A wedge excision of upper and lower eyelids were performed, and these specimens were sent for permanent fixation . lateral tarsal strips by denuding the eyelid margin epithelium and recessing the anterior lamella to reveal a robust lateral tarsal strip of the upper and lower eyelids. A suture was passed in a horizontal mattress each created lateral tarsal strip, then passed intraorbitally in the region of Whitnall's tubercle incorporating a purchase of periosteum during the exit of the needle from the orbit through the canthotomy site, roughly 2mm above the medial canthal tendon. Gentle bipolar cautery was used to shrink exposed lacrimal gland tissue. The lid margin position was then checked . The skin edges were then reapproximated with gut suture. Kenalog-10 was injected subconjunctivally into the right upper eyelid.
SuperCoder Answered Wed 24th of June, 2020 12:07:42 PM

Hi,

Our team is working on this and will get back to you soon.

Thanks.

SuperCoder Answered Thu 25th of June, 2020 11:08:52 AM

Hi,

Thanks for your patience.

Please find below the list of CPT codes as per the first query posted.

Rt lower eyelid ectropion repair - 67917 –E4 (USE this code if extensive repair of ectropion is performed. Use CPT code – 67916,59 for ectropion repair performed through excision tarsal wedge resection OR CPT code – 67915,59 for repair of ectropion performed through thermocauterization.

Rt upper eyelid full thickness wedge resection 1/3 eyelid margin – 67961-E3, 59

Rt conjunctivoplasty with rearrangement – 68320-RT, 59

Rt lateral tarsorrhaphy – 67875-RT

We have received a operative note in follow-up question. We do not provide coding of the operative note in AAE forum. If in case, u want coding for the operative note you can contact on below mentioned contact.

AAE does not provide coding for operative reports and chart notes.

SuperCoder offers SuperCoding on Demand (SOD) (http://www.supercoder.com/coding-answers/coding-on-demand) for coding of an operative report or chart note and you can contact (866)228-9252 or e-mail customerservice@supercoder.com for more information.

Thanks.

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