Ophthalmology and Optometry Coding Alert

Reader Questions:

Describe Graft Revision With 66250

Question: After a pterygium removal, the patient's conjunctival allograft dislocated. The ophthalmologist repositioned and sutured the conjunctival graft. Should I use 66250? Do I need a post-op modifier?Florida SubscriberAnswer: Yes. CPT code 66250 (Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure) describes the repair the ophthalmologist performed. Because 66250 is not bundled into the pterygium removal code, you won't need a modifier. If the ophthalmologist feels that his work was more extensive than 66250 describes, you could report 66999 (Unlisted procedure, anterior segment of eye). Reporting the unlisted-procedure code requires you to submit the operative report, and the claim will go through a review with the carrier. If the problem occurred during the post-op period, be sure to report the revision code with modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period).
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