tci Outpatient Facility Coding Alert - 2013 Issue 2

Reader Question: Start Claims by Verifying Correct Anesthesia Code

Question: We billed 00140 for eye surgery 15823 and modifiers QS, LT with a total of 3.5 units. Medicare said the modifier is inconsistent or that the claim is missing a modifier. What did we do wrong? Minnesota Subscriber Answer: The surgical code was 15823 (Blepharoplasty, upper eyelid; with excessive skin weighting down lid) and you reported 00140 (Anesthesia for procedures on eye; not otherwise specified) as the associated anesthesia code. When you look at the ASA Crosswalk, it lists the correct anesthesia code for 15823 as 00103 (Anesthesia for reconstructive procedures of eyelid [e.g., blepharoplasty, ptosis...

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