MAY 13, 2021
Billing Corneal Hysteresis More Than Once
Question: Can corneal hysteresis be billed again after an intervention such as an SLT or starting new medication?
Answer: Coverage, or lack thereof, may be published on the unique payer's website. Medicare, for example, has an allowable amount, but corneal hysteresis is not a covered benefit. You may need to refer to your payer policies and consider having the Medicare patient. Sign an Advance Beneficiary Notice (or ABN, see the new one mandated use of Jan. 1, 2021) and append modifier -GA to 92145. When the physician deems the test medically necessary, then it’s OK to bill again, unless the unique payer policy states otherwise. Typically, payment is coming from the patient’s pocket.