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Ophthalmology and Optometry Coding Alert

Reader Questions:

Justify 2 Injections With 59

Published on Sun Aug 28, 2005

Question: If the ophthalmologist performs two separate intravitreal injections on the same day for Macugen and Kenalog, can I report 67028 twice? Would I need to use a modifier?


Oklahoma Subscriber


Answer: A carrier processing this claim will probably view the second procedure as a duplicate and thus not payable. You may try using a "2" in the units field on your claim, but you might be more successful coding 67028 (Intravitreal injection of a pharmacologic agent [separate procedure]) on two lines, appending modifier 59 (Distinct procedural service) to the second injection code.
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