CCI Coding and Blepharoplasty Codes

Published: 05th July 2010
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With the latest CCI edits 16.1 going into effect on April 1, you should take a look at your eyelid surgery claims.

If your practice carries out blepharoplasty procedures on the eyelid, take note of the fact that CCI bundles blepharoplasty codes 15820-15823 (Blepharoplasty ...) with the following wound repair codes:

12011-12018

12051-12057

13150-13152

These new bundles indicate that Medicare Part B contractors and other insurers who follow Medicare's lead deem the work involved in wound repair to be an integral part of the blepharoplasty procedures. CCI marks these new code bundles with modifier indicator 1, allowing you to report the bundled codes together when called for, with the right modifier appended to the column 2 code.

Here's an example: A dermatologist carries out a blepharoplasty of the left upper eyelid and repairs a 2-cm wound on the patient's cheek. First you should Report 15822 (Blepharoplasty, upper eyelid) with LT (Left side) appended. Then report 12011 with modifier 59 appended to show that it was a separate service.

But remember that Bleph isn't always cosmetic. Although payers do consider some blepharoplasty surgeries cosmetic and therefore medically unnecessary, payment depends on the procedure and the patient's main compliant.

For the complete list of CCI edits and to get more insight on how it's going to affect your dermatology coding, sign up for a one-stop medical coding guide. When you sign up for one, you'll stay on top of all the changes that CCI coding brings about. You can also go for a free trail before actually signing up for one.



With the latest CCI edits 16.1 going into effect on April 1, you should take a look at your eyelid surgery claims.


If your practice carries out blepharoplasty procedures on the eyelid, take note of the fact that CCI bundles blepharoplasty codes 15820-15823 (Blepharoplasty ...) with the following wound repair codes:


12011-12018


12051-12057


13150-13152


These new bundles indicate that Medicare Part B contractors and other insurers who follow Medicare's lead deem the work involved in wound repair to be an integral part of the blepharoplasty procedures. CCI marks these new code bundles with modifier indicator 1, allowing you to report the bundled codes together when called for, with the right modifier appended to the column 2 code.


Here's an example: A dermatologist carries out a blepharoplasty of the left upper eyelid and repairs a 2-cm wound on the patient's cheek. First you should Report 15822 (Blepharoplasty, upper eyelid) with LT (Left side) appended. Then report 12011 with modifier 59 appended to show that it was a separate service.


But remember that Bleph isn't always cosmetic. Although payers do consider some blepharoplasty surgeries cosmetic and therefore medically unnecessary, payment depends on the procedure and the patient's main compliant.


For the complete list of CCI edits and to get more insight on how it's going to affect your dermatology coding, sign up for a one-stop medical coding guide. When you sign up for one, you'll stay on top of all the changes that CCI coding brings about. You can also go for a free trail before actually signing up for one.





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