SEP 15, 2016
Coding Top 10: CPT Codes for Unscheduled Patients, Appropriate Billing of Postoperative Exams
Coding Top 10, September 2016
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September's coding questions highlight topics ranging from CPT codes for unscheduled patients and appropriate billing of postoperative exams.
- Appropriate Billing of Postoperative Exams
Our physician’s schedule is quite full and there are times when we are unable to see post-surgical patients during the global period. Can we bill for an exam if the first post-surgical visit is outside the global period?
- Denial for Fitting of Bandage Contact Lens
Our practice keeps receiving denials for the fitting of bandage contact lens. We submit CPT codes 99213 -25, 65435 –RT Removal of corneal epithelium and 92071 –RT Bandage contact lens fitting for these services. Medicare keeps paying the exam and procedure only.
- Timing of Postoperative Period
Does the global period start from the comprehensive examination date or the surgical date?
- Appending Modifier to Injections
I recently heard we should add a modifier to injection code 67028 when the physician performs it bilaterally. Do I need modifier -50 indicating bilateral or modifier -RT and -LT?
- Related Exams During Global Period
A patient with punctal plugs came back within 10 days with the same complaints. We submitted 92012 with modifier -24 for the same diagnosis. The payer denied the claim, stating that the procedure payment includes this. Do I need to change the diagnosis?
- Postoperative Complication Billing
I have a case where the physician performed cataract surgery without complication. On the first postoperative day, the patient developed a significant wound leak. The patient came in and the physician sutured the incision in the operating room. How should we submit this?
- CPT Codes for Unscheduled Patients
Is there a specific code for seeing patients as an unscheduled work-in during or after-hours?
- Co-Surgeon Billing of IOL Repositioning
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.
- Medical Diagnosis with Refractions
We find some payers cover a refraction annually with a medical diagnosis. Should our practice submit medical or vision diagnoses on refractions?
- Bundling YAG Vitreolysis and Capsulotomy
I am trying to determine if CPT code 67031 YAG vitreolysis is bundled into CPT code 66821 YAG capsulotomy and have been unable to find the answer