Ophthalmology and Optometry Coding Alert

Question: If a physician removes multiple foreign bodies from the same cornea (65220*-65222*), can we bill for the multiples using the -51 modifier, or can we only use the procedure code once no matter how many are removed?

California Subscriber

Answer: CPT codes 65220* (removal of foreign body, external eye; corneal, without slit lamp) and 65222* (removal of foreign body, external eye; corneal, with slit lamp) should be used for removal of a single foreign body or for multiple foreign bodies. Do not use the modifier -51 in this case. It would be inappropriate to charge separately for the removal of each one of the foreign bodies. One way that you could get paid for the extra service is to append the modifier -22 (unusual procedural services) and briefly explain why the service was greater in the operative note, but this does not always get reimbursed.