• Coding Top 10: IOL Biometry Use of -TC and -26, Telehealth Retina Codes

    Coding Top 10, July/August 2017

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    The July/August coding top 10 selections include billing IOL biometry with modifiers -TC and -26, using telehealth retinal codes and reporting wastage for two Medicare patients who received medical botox the same day from the same vial.

    1. Unbundling Pars Plana Vitrectomy and Prophylaxis of Retinal Detachment 
      Can we unbundle CPT codes 67036 Pars plana vitrectomy and 67145 Prophylaxis of retinal detachment; photocoagulation with modifier -59 when performed simultaneously with or without tear?
    2. Billing for a Partially Removed Crystalline Lens 
      During cataract surgery, the surgeon could not remove the lens. However, the surgeon placed the intraocular lens. What CPT code should I submit?
    3. IOL Biometry Use of -TC and -26 
      Should our practice bill IOL biometry with modifiers -TC for the technical component and -26 for the professional component?
    4. Sample Drug Billing 
      If we provide a sample drug to a patient, can we bill the injection to the payer?
    5. How to Bill Wastage for Botox and Two Patients 
      We have two Medicare patients who received medical botox the same day from the same vial. One received 50 units and the other 25, leaving 25 units wastage. What is the best way to report this?
    6. Telehealth Retinal Codes 
      Our primary care group has a fundus camera. They want to perform the test and have our physician provide the interpretation and report. How do we submit these services?
    7. CPT Code for Removal of Sebaceous Cyst 
      What is the appropriate CPT code for the removal of a sebaceous cyst on the left lower lid with suture closure?
    8. Scribe Requirements for 2017 
      Is it true that our scribes no longer need to be certified?
    9. CPT and ICD-10 for Removal of IOL 
      Our surgeon removed a patient’s intraocular lens due to endophthalmitis. We have had repeated denials when submitting CPT code 66940 Removal of lens material; extracapsular appended with ICD-10 code T85.79XS Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, sequela. How we can get this claim processed?
    10. How to Document Gonioscopy Interpretation 
      Does a gonioscopy require an interpretation and report in addition to the drawing?