DEC 11, 2019
CPT code 15004 Denied by Medicare
Question: Our surgeon performed and billed for CPT code 67966 Excision and repair of eyelid, along with 15004 Surgical preparation of recipient site. Medicare denied 15004. The surgeon feels this is incorrect. Should we have billed this differently?
Answer: According to the CCI bundling edits, 15004 is bundled into 67966. Only 67966 should have been submitted as it includes surgical preparation of the recipient site.
Learn more about bundling edits in the Coding Coach and the Oculofacial Coding Module.