SEP 28, 2017
Billing for ICL
Question: A patient had an implantable contact lens procedure in March of this year. The lens is now causing problems, so our surgeon will exchange it. Can we bill this follow-up procedure to the payer?
Answer: First confirm what your agreement with the patient includes when the patient pays out of pocket for the original procedure.
The only billable procedure is CPT code 65920 Removal of implanted material, anterior segment of eye. Since the implantation is not medically necessary, no code exists to submit that to the payer. The likely diagnosis is T85.29XA Other mechanical complication of intraocular lens, initial encounter.
Learn more about implantable contact lenses in the 1-Hour Coding Course: Complete Guide to Documenting and Coding Cataract Surgery and Ophthalmic Coding: Learn to Code Cataract and Anterior Segment.