CCSD code C3920 – Cauterisation of conjunctival lesion

Key takeaways

CCSD code C3920 covers cauterisation, including cryotherapy, of a conjunctival lesion in Chapter 4, Eye and orbital contents.

The technique decides the code. Destroying the lesion is C3920, while cutting it out or sampling it is C3910.

The operating note must name the technique, the eye treated and the lesion’s position, or the claim invites a query.

Confirm cover and pre-authorization with the insurer before the procedure, even though C3920 carries a Minor 2 band.

Healthcode is the standard route for sending C3920 claims to UK private medical insurers.

CCSD code C3920 is the code for destroying a conjunctival lesion

CCSD code C3920 is the procedure code for cauterisation, including cryotherapy, to a conjunctival lesion. UK private medical insurers read it as one clear message. A lesion on the conjunctiva was destroyed in place.

The code sits in Chapter 4 of the CCSD schedule, Eye and orbital contents, under the Conjunctiva category. It carries a Minor 2 complexity band, which fits a short procedure often done under local anesthetic. To look up a neighboring eye code, use our searchable CCSD codes list.

C3920 describes what the surgeon did, not why. Many insurers also ask for an ICD-10 diagnosis, so record what the lesion was alongside the code.

What C3920 covers, and where its scope stops

Think of C3920 as the destruction code for the conjunctiva. It applies when the ophthalmologist removes a lesion by burning or freezing it, rather than cutting it away.

C3920 covers:

• Cautery applied to destroy a lesion on the conjunctiva
• Cryotherapy to a conjunctival lesion, which the descriptor names directly

C3920 does not cover:

• Excision or biopsy of a conjunctival lesion, which is C3910
• Radiotherapy to a conjunctival lesion, which is C3950
• Treatment to the eyelid skin, cornea or other structures outside the conjunctiva

Unsure which side of the line a case falls on? Read the operating note before you build the claim. The technique recorded there decides the code, not the booking.

C3910, C3920 and C3950 differ by technique, not by lesion

The three conjunctival lesion codes treat the same structure in different ways. Choosing between them comes down to what the surgeon physically did.

Combined procedures need extra care. Claiming C3910 and C3920 for the same lesion in one session is generally not supported.

Two separate lesions, each treated differently and documented as such, are a different case. Check the insurer’s rules before you claim both. Radiotherapy follows its own route under C3950.

A clear operating note is what gets a C3920 claim paid

Insurers rarely question a minor eye procedure that is documented well. They do query a note that leaves the technique vague, or one that reads like an excision.

Record these points in every C3920 operating note:

• The eye treated and the lesion’s position on the conjunctiva
• The lesion’s size and appearance, plus the working diagnosis
• The technique, named plainly as cautery or cryotherapy
• The anesthetic used, such as topical drops or a local injection
• Whether tissue went to histology, because a sample points to C3910 instead
• Consent, the follow-up plan, and the surgeon’s name and signature
• The pre-authorization reference from the insurer

A template helps most in a busy list. Every surgeon records the same points, so the billing team never has to chase a missing detail.

Pre-authorization still comes first for a Minor 2 procedure

A Minor 2 band does not remove the need for approval. Most UK private medical insurers expect the patient to contact them before treatment.

Before the appointment, confirm three points with the patient’s insurer:

• The policy covers outpatient or day-case eye procedures
• The insurer accepts C3920 from the treating specialist
• The authorization number, plus any limits attached to it

Each major insurer publishes a lookup tool for its codes or fees. Use these to check C3920 before you book.

Rules change, so check at the time of booking rather than trusting last year’s answer. For one insurer’s approach in depth, see our guide to Bupa CCSD codes.

How to submit a C3920 claim through Healthcode, step by step

Healthcode is the main electronic route for CCSD claims to UK private medical insurers. A clean submission follows the same order every time.

1. Pull the authorization number from the insurer’s confirmation or the patient record.
2. Match the patient’s name, date of birth and membership number to the insurer’s record exactly.
3. Enter C3920 as the procedure code, dated the day the procedure took place.
4. Add the diagnosis if the insurer asks for one.
5. Enter your fee in line with your agreement with that insurer.
6. Add the treating specialist’s details and insurer provider number.
7. Submit the claim, then watch its status.

Healthcode returns an acknowledgment once the claim arrives. A rejection usually names the field at fault, so correct it and resubmit the same week.

A worked example shows how one session can carry two codes

Here is the technique rule in practice. A patient attends with two conjunctival lesions in the right eye.

The surgeon excises the larger lesion and sends it to histology. The smaller one, a recurrence, is treated with cryotherapy.

The note describes each lesion separately, with its position, size and technique. The claim then lists C3910 for the excision and C3920 for the cryotherapy.

Before submission, the practice confirms the insurer accepts both codes together and that the authorization covers both. Had the surgeon excised one lesion and then frozen its base, the claim would normally carry one code, not two. The decision path below sets the single-lesion and two-lesion cases side by side.

Why C3920 claims come back denied

Most denials trace back to admin slips, such as a missing authorization or a mistyped membership number. The table shows the usual causes and the fix for each.

Run this checklist before you submit a C3920 claim

Two minutes here saves a rejection later. Tick off each point before the claim leaves the practice.

• The operating note is signed and names cautery or cryotherapy.
• No excision or biopsy is recorded for the same lesion.
• The authorization number is on the claim.
• Patient and policy details match the insurer’s record.
• The diagnosis is included where the insurer asks for it.
• The fee matches your agreement with that insurer.
• The treating specialist is recognized by the insurer.

Common C3920 coding mistakes are easy to avoid

A few errors come up again and again with this code. Each one has a simple fix.

Coding from the booking. The appointment may say “lesion removal”, but the plan can change once the surgeon examines the eye. Always code from the signed note.

Looking for a separate cryotherapy code. The descriptor already includes cryotherapy. Freezing a conjunctival lesion is still C3920.

Treating the band as a price. Minor 2 describes complexity. Your fee comes from your agreement with each insurer.

Leaving out the diagnosis. The code shows what was done. Without a diagnosis, the insurer cannot see why it was needed.

How Pabau keeps C3920 claims accurate from note to payment

Many practices still type claims by hand from the operating note. That is where membership numbers get mistyped and authorization references go missing.

Pabau’s claims management software builds the claim from the patient record instead. The CCSD code, patient details and insurer information carry across. The claim cannot be sent until its required fields are complete.

In the UK, claims go to insurers through Pabau’s Healthcode integration, with claim status tracked in one place. The same software submits claims through Claim.MD in the US and Tyro Health in Australia.

Your surgeon and coder still choose the code. Pabau then carries it to the insurer with every required field filled in.

Send cleaner C3920 claims to insurers

Pabau pre-fills claims from the patient record, checks required fields before sending, and submits CCSD claims through Healthcode. See how it fits your ophthalmology practice.

Book a demo

Conclusion

C3920 is one of the simpler codes in the eye chapter, provided the note and the code agree. If the surgeon destroyed the lesion with cautery or freezing, C3920 is right. If tissue was cut out or sampled, the claim belongs under C3910.

Put your effort into two steps, the operating note and the authorization check. Together they prevent most of the rework that follows a minor eye procedure claim.

If your team still re-keys claims by hand, fix that step next. Book a demo to see how Pabau turns a signed operating note into a complete Healthcode claim.

Continue your research

Removing the lesion instead of destroying it? CCSD code C3910 covers excision and biopsy of a conjunctival lesion.

Treating the lesion with radiation? CCSD code C3950 explains how radiotherapy to a conjunctival lesion is billed.

Billing other eye procedures? CCSD code C0620 walks through drainage of the orbit from the same chapter.

Billing Bupa patients? Bupa CCSD codes explains how Bupa uses the schedule and checks codes.

Frequently asked questions