• Payer Guidelines for Comanagement


    Question: When pterygium excision is performed, and the payer does not recognize the comanagement modifiers, is there a way for the comanaging physician to get reimbursed?

    Answer: When the payer doesn't recognize the comanagement modifiers, the surgeon must manage the postoperative care. If the patient returns to the referring physician on their own, an office visit may be billed. However, insurance anticipates the surgeon will care for the patient for the entire global period.

    Learn more about comanagement in Ophthalmic Coding: Learn to Code the Essentials.