tci Outpatient Facility Coding Alert - 2019 Issue Q4

Reader Question: Choose Between 68110, 68115 for Pinguecula Removal

Question: What code should I report for the removal of pinguecula? Michigan Subscriber Answer: Pinguecula is, according to Dorland’s Illustrated Medical Dictionary “a yellowish spot of proliferation on the bulbar conjunctiva near the sclerocorneal junction, usually on the nasal side; seen in elderly people.” With respect to coding, you may consider this procedure synonymous with that of an excision of a conjunctival lesion. Depending on the size of the lesion, you may report one of the two following codes: 68110 (Excision of lesion, conjunctiva; up to 1 cm) 68115 (… over 1 cm).  ...

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