AUG 04, 2023
Bilateral Macular Degeneration with Single-Eye Treatment
Our retina specialist sees a patient for wet macular degeneration OU H35.3231 and only injects the right eye. Do we link the bilateral ICD-10 to the injection code and drug even though we are only treating one eye?
Answer:
The ICD10 code with laterality for the right eye, H35.3211, should be linked to the intravitreal injection, CPT code 67028, as that supports the medical necessity for the procedure. If a separately billable exam was performed and meets the definition of modifier –25, link the bilateral diagnosis to the office visit code.
If you missed the 2023 Fundamentals of Ophthalmic Coding Course, presented June 27 in collaboration with the Academy’s YO Committee, you can purchase the recording through Aug. 25.