Reader Question:
Append 58 to Excision After Incision
Published on Sun Aug 12, 2012
Question: The ophthalmologist incised a patient's conjunctival cyst (68020). One week later, the patient came back with the same problem, and the ophthalmologist excised the cyst. Can I report the excision with a modifier, or does the fact that it's a related procedure within the postoperative period of the first procedure forbid it? Wisconsin Subscriber Answer: The fact that the excision -- 68110 (Excision of lesion, conjunctiva; up to 1 cm) or 68115 (... over 1 cm) -- is a more extensive procedure than the incision the ophthalmologist performed earlier (68020, Incision of conjunctiva, drainage of cyst) allows you to report 68110 or 68115 with modifier 58 (Staged or related procedure or service by the same physician during the postoperative period). Key: Even though the ophthalmologist may not have planned or staged the excision at the time of the incision, CPT's explanation of modifier 58 allows for physicians to use it to [...]