AUG 04, 2023
Unbundling Ptosis Repair and Blepharoplasty
If the surgeon performs a bilateral repair of blepharoptosis (CPT code 67904) and bilateral upper lid blepharoplasty (CPT code 15823), would we add modifier –59 to unbundle?
Answer:
These two CPT codes are bundled under national correct coding initiative (CCI) edits with an indicator of 1, comprehensive. The only time unbundling is appropriate is when CPT code 15823 is performed on one eye and CPT code 67904 is performed on the other, which is quite rare.
If you missed the 2023 Fundamentals of Ophthalmic Coding Course, presented June 27 in collaboration with the Academy’s YO Committee, you can purchase the recording through Aug. 25.