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Ophthalmology and Optometry Coding Alert

Myth Buster:

Don't Let These Bilateral Blunders Stall Your Pay for Pre-Cataract Surgery Tests

Published on Mon Jul 26, 2010

Improperly coding IOL Masters or A-scans can cost your practice $30 per patient.Calculating intraocular lens power for patients facing cataract surgery has gotten more precise as A-scan and IOL Master technology has advanced. But to make sure your practice is getting fairly reimbursed each time, you need to understand the bilateral rules for 76519 and 92136.Could one of these myths be damaging your claims?Include Bilateral and Unilateral Components in Global CodeMyth: If the ophthalmologist calculates IOL power in both eyes, you should report 76519 (Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation) or 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) twice (e.g., 76519-RT and 76519-LT, or 76519-50).Reality: You should not report 76519 or 92136 with modifier 50 even if the ophthalmologist calculated the IOL power of both eyes, warns Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, Director, Best Practices-Network Operations at [...]
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