Wiki 0191T with cataract surgey

[clovemichaud]

Hi, I am new to coding ophthalmology surgeries. My office and I are trying to figure out how to correctly bill an I-stent with a cataract surgery on the institutional claim form. We received some CO97 denials on the claims we have billed with them so far. My questions are: Does the 0191T need a special modifier when billed with a cataract surgery code, such as 66984? Also, since there are no diagnosis pointers on the institutional claims, how do you correctly assign diagnosis codes to this claim so that the 66984 is associated with a cataract diagnosis, but the 0191T is associated with a glaucoma diagnosis? Would the claim deny if you separate the two procedures on two different claim forms so that you can appropriately identify the diagnosis for each?

 

[jeashore]

I am also new to Ophthalmology coding too and I have come across several of these cases performed together. The cpt with the highest charge should be listed first. Also, the only modifier needed for each of these procedures is RT or LT.

Hope this helps, I'm constantly researching and trying to understand and learn ophthalmology coding.

 

[dru_rosen]

0253T with 66984 -

I am also new to Ophthalmology coding too and I have come across several of these cases performed together. The cpt with the highest charge should be listed first. Also, the only modifier needed for each of these procedures is RT or LT.

Hope this helps, I'm constantly researching and trying to understand and learn ophthalmology coding.

- - I use the stent code first then cataract code second. And I agree, only RT/LT modifier is used on the cataract code. I would love to see certification in Ophthalmology as there is a lot of conflicting information out there. I see some posts billing cataract removal with a planned or unplanned vitrectomy is okay, but when I research this topic via Medicare, it's un-bundling.