Wiki Surgery coding changes in 2024?

[StephGeorgeson]

We’ve been billing/been reimbursed for OMNI/iTrack procedures with 66174, depending on payer. The payers that won’t accept 66174, we’ve been using 66999. According to the billing department we outsource to, all of these procedures will be coded 66999, regardless of payer in 2024. From my understanding since we now have to use the unlisted code, we wont be reimbursed for the Omni, iTrack, or Streamline procedures we were reimbursed for this year. Has anyone else heard of these changes?

 

[TThivierge]

Hello Steph G
The unlisted CPT codes are usually not refundable in all medicine specialties from most payers. Id get CPT close to the surgery completed and see if something added since more surgery or treatment work done or less or more complex treatment done. Add modifier 22 or 52 to a CPT close to documentation of treatment but send in medical record of the procedure.
On the clinical scenario above use CPT 65820 & 66990 instead of CPT 66174 or 66999. Ahh what dx code are you using? Check the NCCI website too for more help.

More info......Goniotomy—long considered a leading surgical option for pediatric glaucoma—has reemerged as a treatment for adult glaucoma, driven primarily by advances in minimally invasive glaucoma surgery. Goniotomy, such as that performed with the Kahook Dual Blade (KDB; New World Medical), is a minimally invasive surgical option for glaucoma. The procedure does not violate the scleral wall and is not associated with a bleb.

Well hope this data helps you
Lady T