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  • Oculofacial Coding Updates Modifiers

    Oct. 1 CCI Edits Impact Biopsy and Integumentary Lesion Excision Codes


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    CMS has released the current Correct Coding Initiative Edits (CCI), Version 24.3, which goes into effect Oct. 1. These edits bundle two or more services together. Always look at each code combination when two or more services are being performed as not all codes show a bundle. Often the lower allowable service is bundled into the higher allowable service.

    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 Indicator
    11101 Biopsy of skin; single lesion

    10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance

    		 1
    11101 each separate/additional lesion 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1
    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 67810 Incisional biopsy of eyelid skin including lid margin  1
    11441 excised diameter 0.6 to 1.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11442 excised diameter 1.1 to 2.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11443 excised diameter 2.1 to 3.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11444 excised diameter 3.1 to 4.0 67810 Incisional biopsy of eyelid skin including lid margin  1
    11446 excised diameter over 4.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less 67810 Incisional biopsy of eyelid skin including lid margin  1
    11641 excised diameter 0.6 to 1.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11642 excised diameter 1.1 to 2.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11643 excised diameter 2.1 to 3.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11644 excised diameter 3.1 to 4.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    11646 excised diameter over 4.0 cm 67810 Incisional biopsy of eyelid skin including lid margin  1
    37609 Ligation or biopsy, temporal artery 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1
    61332 Exploration of orbit (transcranial approach); with biopsy 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1
    65410 Biopsy of cornea 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1
    67400 Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1
    67450 for exploration, with or without biopsy 10021 Fine needle aspiration; without imaging guidance
    10022 with imaging guidance    		 1