Ophthalmology and Optometry Coding Alert

Reader Question:

Beware of Repeat Laser Period

Question: A patient returns during the 90-day postoperative period of a focal laser for a repeat laser due to the eye still bleeding. Should I use modifier 58 or 78 on 67210?Pennsylvania SubscriberAnswer: You should not use 67210 (Destruction of localized lesion of retina [e.g., macular edema, tumors], 1 or more sessions; photocoagulation) again during the same 90-day period, even with modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) or modifier 78 (Unplanned return to the operating/procedure room by the same physician or non-physician provider following initial procedure for a related procedure during the postoperative period).. The code's descriptor specifies, "one or more sessions" plural. The AMA considers the code for retina lasers to be a repeat service, or a series treatment. The Medicare Physician Fee Schedule assigns the code a 90-day global period so all repeat treatments during that period are [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Ophthalmology and Optometry Coding Alert

View All