SEP 12, 2016
Co-Surgeon Billing of IOL Repositioning
Question: In conjunction with the cataract surgeon, I performed a pars plana vitrectomy and participated in retrieval and repositioning of the IOL. When I billed for this, I received a denial from the payer stating the diagnoses do not apply. Can you assist? I submitted CPT codes 67036 –RT and 66825 -62 -51 –RT?
Answer: CPT code 66825 for repositioning the IOL doesn't qualify for modifier -62 Co-surgery or modifier -80 Assistant at surgery. Appending these modifiers will also cause the payer to deny the other surgeon's claim. Submit CPT code 67036 -RT. Use ICD-10 code T85.398A Mechanical complication of IOL, initial encounter.