Ophthalmology and Optometry Coding Alert

Question: The doctor performed a YAG laser capsulotomy. Six months later, during a return visit, the patient noted glare, light sensitivity, and decreased vision. The exam showed Elschnig's pearls, and the YAG opening was now smaller than the undilated pupil. The doctor performed a repeat YAG capsulotomy on the same eye. How should we code this? Will it be reimbursed?Florida SubscriberAnswer: Because the second procedure happened outside the 90-day global period for the initial yttrium aluminum garnet (YAG) laser procedure, just report the same code (66821, Discission of secondary membranous cataract; laser surgery [e.g., YAG laser] [one or more stages]) without any modifiers. As long as it was medically necessary, you should have no problem with reimbursement.You can report only one YAG performed on the same eye within the 90-day global period. The phrase "one or more stages" in 66821's definition means that the code includes any number of subsequent YAG sessions within the 90-day global period. Diagnosis: In the ICD-9 manual index, "Elschnig bodies or pearls" directs you to code 366.51 (After-cataract; Soemmering's ring).