Ophthalmology and Optometry Coding Alert

When an ophthalmologist performs a particularly difficult complicated cataract extraction -- one that requires a vitrectomy, for instance -- he's often attracted by the high relative value units (RVUs) of the complex cataract code, 66982. But that code can be a trap, experts say, and can lead to costly denials, even audits.Even if the ophthalmologist thinks he's using "devices or techniques not generally used in routine cataract surgery," this doesn't automatically allow you to report 66982 (Extracapsular cataract removal with insertion of intraocular lens prosthesis [one stage procedure], manual or mechanical technique [e.g., irrigation and aspiration or phacoemulsification], complex, requiring devices or techniques not generally used in routine cataract surgery [e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis] or performed on patients in the amblyogenic developmental stage).4 Questions Point the Way to 66982Ask yourself these questions when you're deciding whether to report 66982:Is the pupil miotic?Is the [...]