Wiki 68801 question correct billing

[cherylbr]

What is the correct way to bill for code 68801 if all 4 punctums are done? (Meaning right upper, right lower, left upper and left lower.)

Also, how would you bill for both punctum of same side? (Meaning left upper and left lower.) Is the use of modifier 50 appropriate in this case?

I am having a lot of denials from the carrier due to what they state as modifier issues.

Please help!

Thank you!

 

[saddie2k]

Hi!
Could you share a bit more info? Did the doc just dilate or were other things done at the same time? What modifiers did you use?

 

[cherylbr]

Hi!
Could you share a bit more info? Did the doc just dilate or were other things done at the same time? What modifiers did you use?
[/QUOTE)

Saddie,
The operative report states: Irrigation and Dilation for all these cases. I am just unsure of how to report these modifiers in each case.

Thanks!

 

[Cheezum51]

Since all 4 puncta were dilated, the carrier may want you to use the E1, E2, E3 and E4 modifiers