Ophthalmology and Optometry Coding Alert

As with other ophthalmology services, the wrong modifier can wreck an AMD claim. Finish your claim with modifiers LT (Left side) or RT (Right side) as appropriate. You might also need to append modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period) or modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). You can use modifier 24 if there is another problem thats not related to the surgery, says Becky Zellmer, CPC, MBS, CBCS, medical billing and coding supervisor for Suby, Von Haden and Associates in Neenah, Wis. Modifier 24 example: The patient sees your general ophthalmologist, has cataract surgery, and sees your  retina specialist during the post-op period for follow-up of wet macular degeneration. The wet AMD is not related to the cataract surgery, so you would append modifier [...]