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"Combined" Surgeries

  1. #1
    Question "Combined" Surgeries
    Medical Coding Books
    Dr. A repositions a dislocated IOL from the posterior to the anterior chamber of the eye - 66825. Dr. B removes the IOL and exchanges with a new IOL -66986. Note that 66825 is bundled into 66986. Both surgeons are in the op room, each performing a separate part of one CPT code (66986). Do you think that this should be billed as co-surgery (66986-62) or should each physician bill their part separately (66825 + 66986)?

  2. #2
    Albany, New York
    Was the initial intent to exchange the lens?
    If so, why reposition and then exchange?

    Per Medicare, 66825 is a component of 66986 that is allowed if an appropriate modifer is present. But, I would have to see more specifics of the OP report to determine if I were going to code 66825 in addition to 66986.
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    During initial cataract surgery, the IOL fell into the posterior section of the eye. Dr. A (retina specialist) is performing a vitrectomy (67036) and repositioning the lens (66825) into the front of the eye. Dr. B (cataract specialist) is exchanging the lens (66986).

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