ED Coding and Reimbursement Alert
READER QUESTION ~ Check for Slit Lamp Use on Corneal FBR Claims
Connecticut Subscriber
Answer: You-ll be able to report a pair of CPT codes in this instance -- one for the E/M and one for the FBR. On the claim:
- report 65222 (Removal of foreign body, external eye; corneal, with slit lamp) for the FBR.
- report 99283 (Emergency department visit for the E/M of a patient, which requires these three key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making of moderate complexity).
- attach modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to 99283 to show that the E/M was a significant and separate service from the FBR.
- link 930.0 (Foreign body on external eye; corneal foreign body) to 65222 and 99283 to prove medical necessity for the encounter.
Remember: If your physician performs corneal FBR without a slit lamp, it affects your code choice. If the physician does not use a slit lamp, you should report 65220 (... corneal, without slit lamp) instead of 65222.
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