MAR 10, 2023
Eyelid Modifiers or Eye Modifiers
What modifier(s) should we use when billing for CPT 11440 – “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less” when the procedure is done on the upper right and lower right eyelids?
Answer:
CPT 11440 has a medically unlikely edit (MUE) of 4 (max number of units that can be billed during same date of service) and is billable on one line with the correct number of units of 2 with -E3 and -E4. Some payers have their own preferred billing guidelines and may want the CPT codes reported on two separate lines.