Wiki modifier help - please tell me

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The eye procedure codes are usually billed with the modifiers that show what eyelid was operated on:
E1 Upper left, eyelid
E2 Lower left, eyelid
E3 Upper right, eyelid
E4 Lower right, eyelid
 
If it is both eyes cant you use modifier 50? However, I cannot see why you couldn't bill it like this 67820 LT an 67820 RT.
 
you cannot use bilateral or RT or LT because those modifiers are for paired organs or body parts, you do not have 2 eyelids you have 4, rt upper and rt lower, lt upper and lt lower, you must be specific, and the E modifiers are specific.
 
mitchellde said:
you cannot use bilateral or RT or LT because those modifiers are for paired organs or body parts, you do not have 2 eyelids you have 4, rt upper and rt lower, lt upper and lt lower, you must be specific, and the E modifiers are specific.
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In the case of the code in question, you are correct - this is a procedure on the eyelids, and you would use separate lines and separate modifier if the epilation is performed on more than one lid. The appropriate modifier(s) would be E1, E2, E3 or E4 depending on which lid(s) were involved.
But do realize that in the case of a procedure on the eye itself, the eyes are paired organs, so you would use LT or RT to designate laterality. The use of modifier -50 vs two lines, is payer driven. I am finding more and more payers want laterality rather than bilaterality.


Karen Hill, CPC, CPMA
 
Hi everyone,

I also need help with this scenario:

The Physician performed trichiasis on a patient with severely ingrown lower eyelashes. Utilizing forceps and biomicroscope, the physician removed four offending lower lashes and one misdirected upper eyelash. What is the correct code for the procedure?

The answer was 67820-RT

I don't understand why they used modifier-RT. Can somebody explain it to me please? I would really appreciate your help. Thanks!
 
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