Wiki Ophthalmology procedures - help please

cyndeew

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Greetings:

I have someone asking me this - she said:

"We have an ophthalmologist who performed a 66982 surgery on a patient, the next day the pt had issues and the Dr saw this pt 3 different times in one day, he would like to bill a 99213 with procedure 65805 and then 99212 with 65805 and another 99212 with 65805, then the pt came back the day after that 2 different times, the Dr would like to bill 9912 with the procedure 65805 and then 99213 with 65805, then again, the pt came in the next day, the Dr wants to bill 99213 with 65805."

This is MASS Health.

The biller has already billed the Cataract procedure. The therapeutic aqueous procedures were done 3 times in one day, 2 the next day and then one more time the 3rd day post op. Can these procedures even be billed considering the cataract surgery has a 90 days global?

Thank you.

Cyndee
 
My guess would be that he wouldn't bill the e&m codes and he would use modifier 78 on 65805. I don't deal with Ophthalmology but that would be what I think!
 
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