Ophthalmology and Optometry Coding Alert

The Health Care Financing Administration (HCFA) has announced that effective May 18 two new intraocular lenses (IOLs) are approved for payment. The new codes are:

Q1001 NTIOL Category 1(AMO Array Multifocal Model SA4ON manufactured by Allergan); and

Q1002 NTIOL Category 2 (elastic ultraviolet-Absorbing Silicone Posterior Chamber, manufactured by STAAR Surgical Company for reduction in astigmatism).

These are the only two new technology IOLs that have been approved by HCFA for payment so far. As other models and manufacturers are approved, HCFA will issue a program memorandum.

The two lenses are eligible for an additional payment of $50 (per lens) when the service is provided in an ambulatory surgical center (ASC). To bill, you must use 66983 (intracapsular cataract extraction with insertion of intraocular lens prosthesis [one stage procedure]), 66984 (extracapsular cataract removal with insertion of intraocular lens prosthesis [one stage procedure], manual or mechanical technique [e.g., irrigation and aspiration or phacoemulsification]), 66985 (insertion of intraocular lens prosthesis [secondary implant], not associated with concurrent cataract removal), or 66986 (exchange of intraocular lens). On the second line-item, list the IOL that was furnished, either Q1001 or Q1002.