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  • Very Minor Ophthalmological Bundling Edits Effective July 1


    Every quarter Correct Coding Initiative Edits (CCI), which bundle two or more codes together, go into effect. There are two columns of codes to watch. When researching edits, the Column 2 code is bundled into the Column 1 code. Always look at each code combination to verify if an edit exists.

    Effective July 1, one edit applies to the chalazion family of ophthalmic codes. The indicator 1 code states there may be times when it is appropriate to unbundle. When unbundling two codes, modifier -59 is appended to the Column 2 code for all payers, with the exception of CMS. Effective July 1, modifier -59, XE, XS, XP or XU can be appended to the code in Column 1 or Column 2 according to MM 11168. 

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

    Column 1

    Column 2

    Indicator

    67800 Excision of chalazion; single 67840 Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure

    1

    67801 Excision of chalazion; multiple, same lid    
    67805 Excision of chalazion; multiple, different lids    
    67808 Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple