Wiki Any input would be greatly appreciated.. new to coding lens and need help thanks

[KELLI]

how to properly bill for the Alcon Toric IOL. This lens in particular was deemed an NTIOL by Medicare in August 2009, which Medicare pays an additional $50 (billed as HCPCS code Q1003) to the ASC. The question is when we bill the for the incremental portion of our cost less the $150 that is included as part of 66982 or 66984, do we then subtract the $50 NTIOL or not???[/SIZE]
Following is an example of how an article states how to correctly charge a Medicare patient for a Toric lens:

$500 Approximate cost of the Toric lens to the facility
-$150 Medicare reimbursement for regular IOL as part of cataract CPT code
- $50 Extra $50 that Medicare reimburses for the use of an NTIOL with code Q1003
$300
+ $50 ASC's cost for shipping and handling of lens ($50 maximum)
– Modest mark-up
$350 Final suggested maximum amount ASC can charge a Medicare patient

Here is the link to the entire article:
http://www.hcpro.com/HOM-239313-8160...-directly.html

This is how we have been billing:

$495 Cost of the Toric lens
-$150 Medicare reimbursement for regular IOL as part of cataract CPT code
$345
+$15 ASC's cost for shipping and handling
$360 Amount billed to physician (on behalf of patient)

 

[elenax]

This is how we bill it:

66984 + Q1003 + V2787...for the Toric lens we charge the patient 450.00...and Medicare pays the other 50.00 = 500.00 the total amount of the Toric lens.

of course, Medicare will not pay for the V2787...billed only for correct coding purposes...

 

[CVelez]

We also subtract the additional $50 payment for the NTIOL giving a total credit of $200 towards the price of the toric lens, as noted in your first example.

Q1003 does end on 02/26/11, so the credit toward those lens would go back to $150

Charla

 

[KELLI]

do you also add a mark up fee for shipping??