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  • Minor Ophthalmological Bundling Edits Effective April 1


    Effective April 1 Correct Coding Initiative Edits (CCI), Version 25.1, has a few edits that impact ophthalmology, focusing on lesion removal codes. All list an indicator 1, stating there are times when it is appropriate to unbundle.

    When reading the edits, the column 2 code is bundled into the column 1 code. Always look at each code combination to verify if an edit exists.

    To see all CCI edits, the Academy provides a link to the Centers for Medicare & Medicaid Services site on the coding updates and resources page. You can also find current edits in the Coding Coach print and online.

    Column 1 Column 2 Bundling Edit
    11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) premalignant lesions (eg, actinic keratosis); first lesion 1
    11310 ; lesion diameter 0.5 cm or less 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) premalignant lesions (eg, actinic keratosis); first lesion
    17110 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
    1
    11311 ; lesion diameter 0.6 to 1.0 cm
    11312 ; lesion diameter 1.1 to 2.0 cm 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) premalignant lesions (eg, actinic keratosis); first lesion
    17110 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
    17111 ;15 or more lesions
    1
    11313 ; lesion diameter over 2.0 cm
    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 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) premalignant lesions (eg, actinic keratosis); first lesion 1
    11441 ; excised diameter 0.6 to 1.0 cm
    11442 ; excised diameter 1.1 to 2.0 cm
    11443 ; excised diameter 2.1 to 3.0 cm
    11444 ; excised diameter 3.1 to over 4.0 cm
    11446 ; excised diameter over 4.0 cm
    11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less
    11641 ; excised diameter 0.6 to 1.0 cm
    11642 ; excised diameter 1.1 to 2.0 cm
    11643 ; excised diameter 2.1 to 3.0 cm
    11644 ; excised diameter 3.1 to 4.0 cm
    11646 ; excised diameter over 4.0 cm
    17110 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions 17003 Destruction premalignant lesions; second through 14 lesions, each (List separately in addition to code for first lesion) 1
    17111 ;15 or more lesions 11310 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less
    17003 Destruction premalignant lesions; second through 14 lesions, each (List separately in addition to code for first lesion)
    1
    17280 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement) premalignant lesions (eg, actinic keratosis); first lesion
    17110 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions
    17111 ;15 or more lesions
    1
    17281 ; lesion diameter 0.6 to 1.0 cm
    17282 ; lesion diameter 1.1 to 2.0 cm
    17283 ; lesion diameter 2.1 to 3.0 cm
    17284 ; lesion diameter 3.1 to 4.0 cm
    17286 ; lesion diameter over 4.0 cm