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Ophthalmology procedures - help please

  1. Default Ophthalmology procedures - help please
    Medical Coding Books
    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
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    www.ambanet.net/AMBA.htm
    AMBACode Coding Software
    http://www.ambacode.net
    2015 AMBA National Medical Billing Conference
    http://www.ambanet.net/2015.htm

  2. #2
    Default
    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!
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

  3. Default
    That's kind of what I was thinking. Thank you!
    Cyndee Weston, CPC, CMC, CMRS
    American Medical Billing Association
    www.ambanet.net/AMBA.htm
    AMBACode Coding Software
    http://www.ambacode.net
    2015 AMBA National Medical Billing Conference
    http://www.ambanet.net/2015.htm

  4. #4
    Default
    No problem Cyndee!!!
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

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