Wiki 67036

[drmom2]

when is it appropriate to unbundle 67028 and 65805 from 67036 using the 59 modifier? What are the key things to put in the procedure note to identify the 67028 and 65805 from the 67036?

 

[smarcolina]

You would use the 59 modifier with these CPT codes because they are usually a component of a more complex service. As for the procedure note it would indicate the Vitrectomy, mechanical, pars plana approach; intravitreal injection of the pharmacologic agent (separate procedure), and Paracentesis of anterior chamber with therapeutic release of aqueous (separate procedure). Hope this helps.
Sharon

 

[dkeown]

Unbundling

I would not unbundle these two codes (67028 & 65805) from 67036 for the simple reason they are related to / a component of the Vitrectomy. If you are performing a procedure that is not related (i.e.: 66852 Removal of lens material; pars plana approach, with or without vitrectomy) then you would append the -59 modifier.

David Keown, CPC, OCS