CPT CODES

CPT Code 67882

CPT code 67882 is used for billing the surgical revision of an eyelid.

Table of Contents
What is CPT Code 67882
Does CPT 67882 Need a Modifier?
CPT Code 67882 Medicare Reimbursement
Are You Being Underpaid for 67882 CPT Code?
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What is CPT Code 67882

CPT code 67882 is used to describe a surgical procedure involving the revision of an eyelid. This code is specifically assigned to complex procedures that may include extensive reconstruction, such as the repair of both functional and cosmetic defects of the eyelid. This could involve techniques like grafting, flaps, or the use of synthetic materials to restore the eyelid's appearance and functionality.

Does CPT 67882 Need a Modifier?

For the CPT code 67882, which pertains to the revision of an eyelid, several 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): This modifier is used to indicate that the procedure was performed on the left eyelid.
2. -RT (Right side): This modifier is used to indicate that the procedure was performed on the right eyelid.
3. -50 (Bilateral procedure): If the revision was performed on both eyelids during the same operative session, this modifier should be used.
4. -51 (Multiple procedures): This modifier is used if multiple procedures were performed during the same session. It helps in adjusting the reimbursement for multiple procedures to reflect the reduced resources required to perform subsequent procedures.
5. -59 (Distinct procedural service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day.
6. -76 (Repeat procedure by same physician): Use this modifier if the same physician had to repeat the eyelid revision procedure during the same session.
7. -77 (Repeat procedure by another physician): This modifier is used if a different physician repeats the eyelid revision procedure during the same session.
8. -79 (Unrelated procedure or service by the same physician during the postoperative period): This is applicable if the eyelid revision is performed during the postoperative period of another unrelated procedure, and it is not covered by the global surgery payment for the initial procedure.
9. -XE (Separate encounter): This modifier signifies that a service that is normally bundled into another service was performed on a separate encounter on the same day.
10. -XS (Separate structure): Indicates that the procedure was performed on a separate anatomical structure.
11. -XP (Separate practitioner): Indicates that a different practitioner performed the procedure in a different encounter on the same day.
12. -XU (Unusual non-overlapping service): This modifier is used to signify that the procedure does not overlap usual components of the main service.

Each of these modifiers provides specific information that can affect billing and reimbursement, ensuring that the services rendered are accurately documented and compensated.

CPT Code 67882 Medicare Reimbursement

CPT code 67882, which pertains to the revision of an eyelid, is generally reimbursable by Medicare. However, the specific coverage and reimbursement amount can vary based on several factors including the medical necessity of the procedure, the region in which the service is provided, and the patient's specific Medicare plan details.

To determine the exact reimbursement amount for CPT code 67882, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website. This schedule provides detailed information on the reimbursement rates for various procedures based on the locality. Additionally, healthcare providers should ensure that proper documentation is maintained to establish the medical necessity of the procedure for successful claims processing.

Are You Being Underpaid for 67882 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to read your contracts and identify discrepancies down to specific CPT codes, such as 67882 for eyelid 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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