Ophthalmology and Optometry Coding Alert

Do you need E1-E4 for punctal plugs and epilation? Thanks to the abundance of bilateral coding rules, remembering whether you should append the eyelid modifiers for procedures like epilation and punctal plug insertions is no easy task -- unless you know these tricks. CPT® provides one modifier for each eyelid: E1 for upper left, E2 for lower left, E3 for upper right, and E4 for lower right. The general rule is to use the E modifiers when a procedure can be performed on any one of the four eyelids -- but real-world coding and billing don’t always allow you to. E1-E4 are informational modifiers which do not affect payment, but they do give the payer more clinical information. Of all the eyelid procedures in CPT® (67700-67999), ophthalmologists commonly perform two procedures that involve specific eyelids: epilation (67820-67835) and punctal plug procedures (68761). Understand Carrier Rules for Multiple Lashes Although there may be [...]