Optometry Coding & Billing Alert

Published on Thu Jul 08, 2004 PDF

67500 is now bundled into all but 16 eye codes

The latest National Correct Coding Initiative edits, effective July 1, make 67500 (Retrobulbar injection; medication [separate procedure, does not include supply of medication]) a component of over 200 eye procedures. Optometrists are usually only permitted to perform retrobulbar injections to administer epinephrine to patients suffering anaphylactic shock -- and even that is a rare occurrence, says Sandy Neigh, CPOA, business manager for Clear Vision Eye Centers in Las Vegas. "We've never had to code for it," she says. "I'm not saying it never happens, but I've never seen it."

All of the 67500 bundles -- the new ones in addition to the existing ones - have a modifier status indicator of "1." This means that you can report the two procedures together under certain circumstances by adding a modifier to 67500 and including documentation with your claim.

For a complete list of NCCI edits, visit the Web site www.cms.hhs.gov/medlearn/ncci.asp.