Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist removed a conjunctival cyst, but did not incise or drain it, only snipped it. How should I code?

Georgia Subscriber

Answer: If the physician documented an excision of the cyst, you’ll report 68110 (Excision of lesion, conjunctiva; up to 1 cm), 68115 (… over 1 cm), or 68130 (… with adjacent sclera).

If the physician does not feel that the procedure they performed qualifies as an excision, then you should report the appropriate office visit code (99202-99215) or ophthalmological service code (92002-92014) for the service.