Does CPT 76519 require a modifier?

No additional payment is made when code 76519-TC or 92136-TC is billed with the bilateral modifier -50. If the technical portion of the procedure is only performed on one eye, the -52 modifier for reduced services should be used as well as the appropriate anatomic modifier (-RT or -LT).

How do you bill for optical biometry?

Q What CPT code describes OCB? A Use 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) to report this service.

How often can you bill for Pachymetry?

Corneal pachymetry can only be paid once per lifetime per provider. If you are seeing a glaucoma suspect patient for the first time, bill for pachymetry this one time only. Once a patients corneal thickness is a matter of record, there is no reason to duplicate the measurement for monitoring subsequent IOPs.

What is ophthalmic biometry?

Optical coherence biometry (CPT code 92136) is an ophthalmic diagnostic test that measures the curvature of the cornea and the depth of the anterior chamber in addition to the axial length of the eye, without ultrasound.

How do you bill bilateral procedures?

Bilateral surgical and nonsurgical procedures are reported as a single code billed (1) with modifier 50, (2) twice on the same day with RT and LT modifiers, or (3) with 2 units.

How do you bill bilateral cataract surgery?

Bilateral Cataract Surgery That being said you will post the surgery 66984 with the -50 modifier and accept the multiple surgery reduction 50% hit on the second eye. Don’t bill with -RT(right) and -LT(left) modifiers and add a -59 modifier on the second eye, that’s begging for an audit and unbundling.

How do I bill Medicare for pachymetry?

The optical pachymetry service should be billed and is valued equivalently to the ultrasonic service (CPT code 76514). Modifier RT, LT, or 50 (bilateral) should be reported with CPT code 92499, as appropriate. CPT code 76514 is reimbursed as a bilateral service (both eyes are included in a single test).

Can you bill pachymetry on Oct?

While OCT may do a great job in measuring corneal thickness, the scan cannot be coded as corneal pachymetry, CPT 76514, which is defined as “ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness).” Instead, you must use CPT code 92132, for which there is …

Is CPT 92136 bilateral?

According to the Medicare Fee Schedule Database (MPFSDB), the global and technical components of CPT codes 76519 and 92136 are BILAT (bilateral) indicator “2” codes and the professional components are BILAT indicator “3” codes.

What is biometry IOL Master?

The IOL Master ocular biometry is a test that measures the size of the eyeball, called axial length, and allows to calculate the dioptric power of the intraocular lenses that are implanted at the end of the crystalline lens, which is the inner lens of the eye that helps to focus better.

How do you code a bilateral joint injection?

The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a bilateral procedure.

Does procedure code 76519 include services performed for procedure 76516?

Procedure code 76519 includes services performed for procedure 76516. Separate reimbursement will not be made for 76516 when billed with 76519; Payment for 76519 and 92136 for the same patient, same provider, and same day will not be made. For claims submitted to the fiscal intermediary or Part A MAC:

When to Bill the professional component for bilateral cataract surgery?

When surgery for bilateral cataracts is scheduled several weeks apart, bill the professional component only when the IOL calculation is done within a timeframe that it can be used for the second planned surgery.

What is the CPT code for bilateral glaucoma surgery?

No additional payment is made when CPT code 76519-TC or 92136 is billed with the bilateral modifier -50. If the technical portion of the procedure is only performed on one eye, the -52 modifier for reduced services should be used as well as the appropriate anatomic modifier (-RT or -LT).

What is the CPT code for ophthalmic biometry?

When billing for an A-scan, use CPT code 76519 Ophthalmic biometry by ultrasound echography, A-scan: with intraocular lens power calculation. Most radiological tests are split between a technical and a professional component.