Using an E/M or eye code to bill for the post-surgical visit instead of the surgical procedure code (like 66984 for cataract removal).
How do you bill a cataract post op care?
The date of service should correspond to the date of the surgery. Use the same surgical CPT procedure code used by the surgeon, but add the -55 modifier to signify that you are rendering the postoperative care. The number of units billed can vary by carrier, so be aware of your carriers requirements.
Does Medicare pay for follow up visits after cataract surgery?
While Medicare typically does not cover vision procedures, it does cover cataract removal so long as the surgery is deemed medically necessary. This includes pre-surgery examinations and follow-up care. Patients will be responsible for paying a 20 percent coinsurance as well as the Medicare Part B deductible.
How do you bill Post op?
Post-operative visits should be reported with CPT code 99024 when the visit is furnished on the same day as an unrelated E/M service (billed with modifier 24).
How do I bill CPT 66984?
IOL insertion, the correct way to code the procedure is by using CPT code 66984 [Extracapsular cataract extraction removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique ( eg, irrigation and aspiration or phacoemulsification)].
How does Goniotomy bill cataract surgery?
Use CPT 65820 (Goniotomy). CPT 65820 is considered a major surgical procedure; CMS defines it as having a 90-day postoperative period.
Does CPT code 66984 need a modifier?
Submit CPT code 66984 with CPT modifier 79, since the second surgery was for treatment of a different eye.
How Much Does Medicare pay for cataract surgery in 2020?
If you’re 65-or older and your doctor has determined surgery for your cataracts to be medically necessary, Medicare will typically cover 80% of your expenses including post-surgery eyeglasses or contacts.
How Much Does Medicare pay for glasses following cataract surgery?
Typically, Medicare Part B — which is outpatient insurance — pays 80% of the expenses related to cataract surgery. This includes one pair of glasses following the surgery. If cataract surgery requires a hospital stay, Medicare Part A — which is hospitalization insurance — will cover it.
Can you bill for post op complications?
Medicare says they will not pay for any care for post-operative complications or exacerbations in the global period unless the doctor must bring the patient back to the OR. This also applies to bringing the patient back to an endoscopy suite or cath lab.
What is the difference between modifier 24 and 79?
Modifier 24 is unrelated E/M service by same Dr. during a postop period. Modifier 79 is unrelated procedure or service by the same Dr. during the postop period.
What does CPT modifier 55 mean?
When a physician or other qualified health care professional performs the postoperative management and another physician performed the surgical procedure, the postoperative component may be identified by appending this modifier to the surgical procedure.