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Posted on September 14, 2012 by · Leave a Comment
Filed under: Ophthalmology  

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Epilation, as you all know, is the removal of ingrown eyelashes. As such, most coders are unable to distinguish between the epilation per eye lid and epliation per eye. Let me tell you folks, you need to be very careful when performing the ophthalmology coding process for the same. For epilation per eye, you can use two important codes. The first one is 67820, which reports the correction of trichiasis and eipation. The mode of procedure is done through the forceps only. You can use the code 67825 to report the correction of trichiasis, but this time using components other than forceps. Cryotherapy, laser surgery and electrosurgery are some of the common examples of the latter process. In the absence of any national Medicare policy, most Medicare carriers recommend coders to code per lid. This trend is also accepted by the HCFA officials. It is strongly recommended to use the eyelid modifiers in order to maximize the reimbursement from Medicare carriers.

Ophthalmology coding: differentiating between Medicare and non-Medicare carriers

Let‘«÷s take an example to understand the epilation coding for private carriers. Imagine that two eyelashes were epilated by the ophthalmologists. One of them was performed in the lower left lid. At the same time, three were performed in the upper left lid and six in the upper right lid using the forceps. In this case, you need to append the code 67820-LT on the first line. On the second line, code 67820-51-RT should be appended. Since they are the same, it doesn‘«÷t matter where you append the modifier -51. This modifier reports the multiple procedures during the session. During the ophthalmology coding process, we normally use the first line to list the highest paying procedure. In any case, you will get half fee for the second procedure and full fee for the first. Industry experts also agree that this is the best way to handle ophthalmology coding routines for epilation procedures and associated payments. Coming back to the ophthalmology coding procedures for Medicare carriers, the same scenario is coded in different way. The code 67520-E2 is used for the lower left eyelid and 67820-E1-51 for upper left eye lid. You can use the code 67820-E3-51 for upper right lid during the ophthalmology coding routines.

Hope the above article was interesting to read and contained useful information. Good day folks!

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