Ophthalmology and Optometry Coding Alert
YOU BE THE CODER ~ Multiple Injections in 1 Visit
Mississippi Subscriber
Answer: The appropriate CPT code to report for the injections is 67028 (Intravitreal injection of a pharmacologic agent [separate procedure]) times three units. You should appeal the claim to the carrier and provide a written explanation as to why three different medications were medically necessary in treating the endophthalmitis for this patient. Send this explanation along with a copy of the medical record notes, the denial and CMS-1500 claim form asking for a review of the charges for payment.
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