How To Use CPT Code 67840

CPT 67840 involves the excision of a lesion of the eyelid, excluding chalazion, with or without simple direct closure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 67840 procedures.

1. What is CPT 67840?

CPT 67840 is a medical procedure code used to describe the excision of a lesion of the eyelid, excluding chalazion, with or without simple direct closure. This code is utilized by medical professionals to accurately document and bill for the specific procedure performed on a patient.

2. 67840 CPT code description

The official description of CPT code 67840 is: “Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure.”

3. Procedure

The 67840 procedure involves the following steps:

1. The patient is appropriately prepped, and the area is anesthetized.
2. The provider outlines the eyelid lesion.
3. The lesion is excised with a margin of healthy tissue.
4. The specimen is submitted to a laboratory for analysis.
5. Any bleeding is cauterized.
6. If necessary, the wound is closed with sutures.
7. An eye pad and dressing are applied.

4. Qualifying circumstances

Patients eligible to receive CPT code 67840 services are those with a lesion on the eyelid that requires excision, excluding chalazion. The lesion may be due to various causes, such as infection, inflammation, or neoplasm. The provider must determine that the excision of the lesion is medically necessary and that the patient’s condition warrants the procedure.

5. When to use CPT code 67840

It is appropriate to bill the 67840 CPT code when a provider performs an excision of a lesion of the eyelid, excluding chalazion, with or without simple direct closure. The code should be used when the procedure is deemed medically necessary and is the most appropriate treatment option for the patient’s condition.

6. Documentation requirements

To support a claim for CPT 67840, the following information should be documented:

• Patient’s medical history and physical examination findings
• Diagnosis and indication for the procedure
• Description of the lesion, including size, location, and appearance
• Details of the procedure, including anesthesia, excision technique, and closure method (if applicable)
• Pathology report for the excised specimen
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 67840, it is essential to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 67840 include:

• Use a modifier to designate the involved eyelid: E1 for upper left, E2 for lower left, E3 for upper right, and E4 for lower right. These informational modifiers provide more clinical information and may reduce payment delays.
• For excision of one or more chalazions, select the appropriate code from the section 67800 to 67850, Excision and destruction procedures on the eyelids.
• For excision and repair of the eyelid by reconstructive surgery, see CPT codes 67961 and 67966.

8. Historical information

CPT 67840 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 67840

Five similar codes to CPT 67840 and how they differentiate are:

• CPT 67800: Excision of chalazion, single; this code is used specifically for the excision of a chalazion, which is excluded from CPT 67840.
• CPT 67801: Excision of chalazion, multiple; this code is also used for chalazion excision but involves multiple chalazions.
• CPT 67805: Excision of skin tags of eyelids; this code is used for the excision of skin tags on the eyelids, not lesions.
• CPT 67808: Excision of lesion of eyelid with flap or graft closure; this code is used when the excision requires a more complex closure method than simple direct closure.
• CPT 67961: Excision and repair of eyelid by reconstructive surgery; this code is used when the excision and repair involve reconstructive surgery, which is not included in CPT 67840.

10. Examples

Here are 10 detailed examples of CPT code 67840 procedures:

1. Excision of a small benign papilloma on the upper left eyelid with simple direct closure.
2. Excision of a basal cell carcinoma on the lower right eyelid without closure.
3. Excision of a sebaceous cyst on the upper right eyelid with simple direct closure.
4. Excision of a nevus on the lower left eyelid without closure.
5. Excision of a pyogenic granuloma on the upper left eyelid with simple direct closure.
6. Excision of a squamous cell carcinoma on the lower right eyelid with simple direct closure.
7. Excision of a molluscum contagiosum lesion on the upper right eyelid without closure.
8. Excision of a xanthelasma on the lower left eyelid with simple direct closure.
9. Excision of a small melanoma on the upper left eyelid without closure.
10. Excision of a keratoacanthoma on the lower right eyelid with simple direct closure.