Optometry Coding & Billing Alert

Published on Fri Jan 07, 2005 PDF

Test your after-surgery smarts and make sure you get every cent you deserve

If you're like the majority of optometry practices, much of your work is postoperative care for patients who recently underwent cataract surgery. Are you sure you're getting the reimbursement you deserve? Take this quiz and avoid the many pitfalls of postoperative care coding and billing.

1. Which modifier should you append to the surgery CPT code to report postoperative management?

a. Modifier -24
b. Modifier -52
c. Modifier -55
d. Modifier -54
e. Modifier -67

2. To properly report postoperative care, your claim should have the same _________ as the claim that the surgeon submits.

a. Fee
b. ICD-9 diagnosis code
c. Physician identification number
d. Modifiers
e. None of the above

3. What percentage of the overall surgical fee for a procedure will Medicare pay for postoperative care for CPT codes 66982 (Extracapsular cataract removal with insertion of intraocular lens prosthesis, manual or mechanical technique, complex, requiring devices or techniques not generally used in routine cataract surgery or performed on patients in the amblyogenic stage), 66983 (Intracapsular cataract extraction with insertion of intraocular lens prosthesis) and 66984 (Extracapsular cataract removal with insertion of intraocular lens prosthesis, manual or mechanical technique)?

a. 10 percent
b. 20 percent
c. 45 percent
d. 50 percent
e. 100 percent

4. The surgeon sees the patient on the 24th day after the surgery, and refers the patient to you for postoperative care. The surgeon is billing for 24 days of postoperative care. You first see the patient on the 36th day after surgery. How many days of postoperative care should you bill for?

a. 66 days
b. 36 days
c. 20 days
d. 90 days
e. 54 days

 5. Assume $700 is the total allowed charge for 66984. Roughly how much should you earn for 45 days of postoperative care?

a. $45
b. $350
c. $200
d. $70
e. None of the above

Note: You can find most of the answers for this quiz in the article "Split the Bill Correctly With -55" in the May 2004 Optometry Coding and Billing Alert.