• Billing for Injection Related to Pterygium Surgery


    Question: For the purpose of disrupting the vascular supply to the pterygium to prevent further growth and to reduce any potential damage to the cornea during the excision, our surgeon wants to inject mitomycin C first, followed by excision at another date. What is billable other than the pterygium excision?

    Answer: The drug package insert states, “Prevention of recurrence of pterygium after its surgical excision.” Therefore, neither the drug or the injection is billable to insurance. Either the patient must pay for the injection and drug or the practice must absorb the cost.

    Learn more about surgeries in the Cornea module.