Wiki Help Me! New to Eye coding :)

[Bells1408]

I'm having a really hard time with the CPT 66984. What date of service do I bill if we are co managing with another physician? Also what modifier am I supposed to be using? I have a few claims that are rejecting because the surgeon billed the day of surgery and the notes I have tell me to use the same date but then my claims reject from the payer. Someone please help me

 

[mrsjehu]

A few questions first. Are you the surgeon's office or the co-managing Dr? This is important because depending on which will depend on what modifier you need to use. You also need to make sure you are both using the same ICD-9 codes as well. I don't believe that you use the date you saw the patient not the date of surgery. I worked for a surgeon's office and we co-managed quite often. We would get phone calls verifying diagnosis code, but not date of surgery.

 

[mzkandyd]

The same dos , CPT and dx code as the primary surgeon. Look at it as the same rules as modifier 80 when it comes to how to bill for it.

 

[alk1021]

To bill co-manage, use the same date of surgery as the ophthalmologist, but add modifiers (RT or LT) and 55 for shared care. The ophthalmologist should be filing with a 54 for their portion of the shared care. Also most insurances require the assumed and relinquished dates of the care. The information for the assumed date should come from your ophthalmologist and the relinquished date should the end of the 90 day post op period. Hope this helps.