Modifier Coding Alert

Question: What modifier should I use when a doctor performs a punctual plug insertion to block excessive drainage of tears on both eyes, upper and lower?

Florida Subscriber

Answer: To be specific and accurate, you should use E1 (Upper left, eyelid), E2 (Lower left, eyelid), E3 (Upper right, eyelid), and E4 (Lower right, eyelid). You’ll attach the appropriate modifier to the procedure code: 68761 (Closure of the lacrimal punctum; by plug, each).

Your coding should look like this:

• Line 1: 68761-E1 (1 unit)
• Line 2: 68761-E2 (1 unit)
• Line 3: 68761-E3 (1 unit)
• Line 4: 68761-E4 (1 unit)

Pointer: You would not use modifier 50 (Bilateral procedure) because that would mean you are only reporting the placement of two plugs, not four.

---