JUN 24, 2020
Referring Physician Billing for Biometry
Question: Can a referring physician order, perform and bill for the IOL master for a patient being sent for a cataract evaluation?
Answer: Although a referring physician can bill for the test, some payers, including Medicare, will recoup payment if the same service is billed by the operating surgeon. Palmetto GBA includes the following language in its policy: “Since the patient and surgeon determine the medical necessity for cataract surgery, only the surgeon may order and receive reimbursement for the professional component of an A-scan or partial coherence interferometry service.”
Learn more about testing services in the Learn to Code the Essentials.