Revenue Cycle Insider

Question: I have procedure notes for two different ophthalmological surgeries for the same patient that took place on the same day. Surgeon A performed a cataract extraction with an intraocular lens (IOL) prosthesis insertion and without endoscopic cyclophotocoagulation. Meanwhile, Surgeon B implanted an Ahmed glaucoma valve with a graft.

How do I report these procedures, and do I need to append modifier 62 to the surgical codes?

Washington Subscriber

Answer: Use 66982 (Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; without endoscopic cyclophotocoagulation) to report the cataract extraction with IOL insertion.

Then, you’ll assign 66180 (Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft) to report the Ahmed glaucoma valve implantation. A surgeon typically performs this procedure to help reduce the intraocular pressure in the eye caused by the glaucoma.

You won’t need to append modifier 62 (Two surgeons) to the codes because the two surgeons are performing two separate procedures — not “performing distinct part(s) of a procedure,” as the CPT^® code set Appendix A explains. You mentioned that you have separate operative notes for each provider, which means you can report 66982 and 66180 on one claim, with each CPT^® code billed under each surgeon’s national provider identifier (NPI). Additionally, the Medicare Physician Fee Schedule has a “0” status indicator listed under the co-surgery column for both 66982 and 66180, which means you are not allowed to report modifier 62 for the procedures.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC