Ophthalmology and Optometry Coding Alert

Question: One of our ophthalmologists performed a bilateral nasolacrimal duct probe. Can I report this using modifier 50?

Oregon Subscriber Answer: Yes, you can report 68810 (Probing of nasolacrimal duct, with or without irrigation) bilaterally using modifier 50 (Bilateral procedure). When you look up 68810 in the Physician fee schedule database, you'll notice a "1" in the "Bilat Surg" column, and you can therefore report 68810-50.

Note: Some payers prefer that you use modifiers LT (Left side) and RT (Right side) instead of 50. Depending on payer preference, you should either list the code once with the bilateral modifier appended (this is the method most Medicare carriers prefer) or list the procedure twice on two lines of the claim form (with the LT appended to the code on the first line and RT appended to the same code on the second line).

Keep in mind: Most payers reimburse bilateral claims at 150 percent of the assigned fee schedule amount.