Ophthalmology and Optometry Coding Alert

Question: How do you code cataract surgery done within the global period of cataract surgery on the other eye?

Anonymous Illinois Subscriber

Answer: Cataract surgery with an intraocular lens implant (66984) is the most common form of this type of surgery. Code 66984 has a global period of 90 days (as do all the cataract surgery codes). You should use modifier
-79 (unrelated procedure or service by the same physician during the postoperative period) and the eye modifier to indicate that the second surgery is unrelated to the first.

Ideally when you did the first eye you would have attached the eye modifier to the procedure code. When you attach the eye modifier to the -79 for the second procedure, the payer can then understand why the two cases are unrelated (different eyes). If you did not provide the eye modifier on the first claim, you may have difficulty with the second claim even though you provide the eye modifier. If you have trouble, simply submit the claim for review with an explanation of the circumstances.