Results 1 to 2 of 2

66984 with 65772

  1. #1
    Default 66984 with 65772
    Exam Training Packages
    I have a Ophthalmologist who is doing cataract surgery (66984) and at the same time is doing a corneal relaxing incision (65772) because his 66984 will cause an astigmatism and he doesn't want to inconvenience the patient by having them come back at a later time to have that fixed.

    The CPT book for 65772 reads "corneal relaxing incision for correction of surgically induced astigmatism" and doesn't state that is can't be billed with the 66984.

    I have referenced the Coders Desk Reference (CDR) and it the description it states "when a previous surgery results in astigmatism, the physician at a later date returns the patient to the operating room to correct the problem," but my provider doesn't like that definition. He thinks if the time factor was important that it would have been listed in the CPT code description. I tried to explain that hte CDR is designed to provide additional information to individuals who don't have a medical background (surgeon, etc) so they better understand the codes, but that wasn't good enough.

    I have used EncoderPro and Craneware to check if there is an edit or if a modifier is allowed and it does allow a modifier. I have also checked the CCI edits on Medicare's website and there doesn't seem to be an issue there either.

    So, can these codes be billed together on the same day? How about the day after? If anyone has concrete evidence, I would appreciate a link to the information. I have read posting that it won't be reimbursed, but with this provider, I better have some hard evidence to show him. I wish there was a way to test codes in the Medicare system to see if they would payable or not so he could see that.

    Any help is apprecaited. PLEASE!!!



  2. #2
    I have billed for an Ophthalmologist for many years and have never been paid for an L.R.I. by an insurance company for astigmatism that was caused by a cataract operation. It has been my experience that the only time an insurance company will consider this procedure for payment is when the patient has had a corneal transplant performed and astigmatism is a direct cause of the operation. We charge the patient out of pocket for this procedure and it is coded as 66999 not 65772. I hope this helps.

Similar Threads

  1. 66821 after 66984
    By Fran Born in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 01-06-2015, 07:46 PM
  2. 66982 or 66984
    By Scatlot in forum Ophthalmology/Optometry
    Replies: 0
    Last Post: 05-17-2013, 02:00 PM
  3. 66984 55
    By lwduley in forum Ophthalmology/Optometry
    Replies: 5
    Last Post: 10-02-2012, 02:08 PM
  4. 66984???
    By KELLI in forum Ophthalmology/Optometry
    Replies: 2
    Last Post: 07-15-2011, 10:48 AM
  5. Billing 66984
    By Cfoster in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 06-08-2009, 12:46 PM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.