Ophthalmology and Optometry Coding Alert

Question: Our ophthalmic surgeon performed a levator resection (67904), an entropion repair (67924) and canthoplasty on the right upper eyelid (67950). CCI bundles 67904 and 67924 as mutually exclusive, and 67950 as a component of 67924 -- but I know I can break those bundles with modifier 59. I'm confused about the sequence of codes and the proper placement of modifiers, though. What order should I list the codes in, and which codes get the modifier? Colorado Subscriber Answer: Before you try to report 67904 (Repair of blepharoptosis; [tarso] levator resection or advancement, external approach), 67924 (Repair of entropion; extensive [e.g., tarsal strip or capsulopalpebral fascia repairs operation), and 67950 (Canthoplasty [reconstruction of canthus]) together, you need to be sure that all three qualify for modifier 59 (Distinct procedural services). Definition: Use modifier 59 "to identify procedures/services that are not normally reported together, but are appropriate under the circumstances," explains Medicare [...]