CPT Code 67835

CPT code 67835 is a medical billing code for surgical revision of eyelashes.

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What is CPT Code 67835

CPT code 67835 is used to document a surgical procedure involving the revision of eyelashes. This typically refers to correcting issues such as trichiasis, where eyelashes grow abnormally and irritate the eye. The procedure may involve techniques like epilation, cryotherapy, or surgical realignment to address the misdirected lashes and alleviate discomfort or potential damage to the eye.

Does CPT 67835 Need a Modifier?

For CPT code 67835, which pertains to the revision of eyelashes, certain modifiers may be applicable depending on the specific circumstances of the procedure. Here is an ordered list of potential modifiers and the reasons for their use:

1. -LT (Left side): Used when the procedure is performed only on the left side of the body. This modifier is necessary to specify which eyelid was involved if only one side was treated.

2. -RT (Right side): Used when the procedure is performed only on the right side of the body. Similar to the -LT modifier, it's used to indicate that the procedure was specific to the right eyelid.

3. -50 (Bilateral procedure): Applied when the procedure is performed on both the left and right sides during the same operative session. This modifier is crucial for accurate billing and reimbursement, as it informs the payer that the procedure was conducted bilaterally.

4. -E1 (Upper left, eyelid): Specifies that the procedure was performed on the upper left eyelid. This level of detail assists in precise documentation and billing.

5. -E2 (Lower left, eyelid): Indicates that the procedure targeted the lower left eyelid. This modifier helps in distinguishing the exact eyelid involved in the procedure.

6. -E3 (Upper right, eyelid): Used when the procedure is performed on the upper right eyelid. It ensures clarity in medical records and claims processing.

7. -E4 (Lower right, eyelid): Specifies that the revision was done on the lower right eyelid. This detail is important for accurate medical documentation and insurance claims.

8. -51 (Multiple procedures): This modifier is used when multiple procedures, other than E/M services, Physical Medicine and Rehabilitation services, or provision of supplies (e.g., vaccines), are performed at the same session by the same provider. It may be necessary if the revision of eyelashes is one of several procedures performed.

9. -59 (Distinct procedural service): Indicates that the procedure was distinct or independent from other services performed on the same day. This modifier is used to signify that the procedure was separate and necessary at the time of surgery.

Each of these modifiers provides specific information that helps in the accurate coding and billing of the procedure, ensuring proper reimbursement and compliance with insurance guidelines.

CPT Code 67835 Medicare Reimbursement

CPT code 67835, which pertains to the surgical revision of eyelashes, is generally not reimbursed by Medicare. This procedure is often considered cosmetic, and Medicare typically does not cover cosmetic surgeries unless they are deemed medically necessary. In cases where the procedure is necessary to correct a functional impairment, documentation supporting the medical necessity must be provided for potential coverage consideration. However, standard reimbursement for this code under Medicare is not typically available, and the amount would not be specified unless under exceptional medically justified circumstances.

Are You Being Underpaid for 67835 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize contracts and identify discrepancies down to specific CPT codes, such as 67835 for eyelash revision procedures, RevFind ensures that each claim is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to for every service rendered.

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