-59 modifier with ophthalmogy codes

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Loxley, AL
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Need help here. We are having a discussion at work about unbundling retina repair with vitrectomy codes and cataract surgeries. The two instances we are discussing are as follows:

#1- 67108 and 66982. In this instance the retina repair was pre planned along with the cataract portion and is documented in the clinical notes. There are two separate incisions made. Payor is Molina.

#2- 67113 and 66982. Basically the same instance as #1- Clinical documentation supports that each procedure was pre planned and the retina repair was not a result of a complication of the cataract surgery. Payor is BCBS.

We are more apprehensive to use the -59 modifier if it was Medicare but we see a lot of the retina detachment repairs along with cataract surgeries that are pre-planned. When would you unbundle? In most instances the cataract surgery is performed first and the wound is closed and found to be water tight. Then, they perform the retina repair with vitrectomy. Sometimes the membrane peel is done and sometimes it's just a 67108. Any input would be appreciated.
 
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