NOV 30, 2022
Follow-Up Exam or Post-Op?
During a post-operative period of a vitrectomy with membrane peel to repair a retinal detachment with a single break, a patient was examined and a new retinal detachment due to proliferative vitreoretinopathy was diagnosed. Since these are different retinal detachment diagnosis codes, are we able to bill the follow-up exam with the appropriate level of evaluation and management (E/M) and modifier -24 or is it post-op?
Answer:This would be considered a post-op visit. Although it’s a separate diagnosis, it would not be billable since it is progression of the disease, related and/or could be a complication of the first surgery.
Find additional coding competency resources in
Fundamentals of Ophthalmic Coding.