Question: Medicare is denying payment for cataract surgery on the second eye. I learned a while ago that if I had four modifiers to append to a CPT code, to put modifier -99 in the last modifier box and note "additional modifiers" in box 19 of the billing form. Since we're in a rural HPSA, we're appending modifier -QB to the code. I'm filing the second eye with 66984-QB-54-99, and additional modifiers -79 and -LT. Answer: Modifier -99 (Multiple modifiers) was required in the past when you needed to list more than two modifiers with a CPT code. Now, most carriers have updated their claims processing systems and can recognize four modifiers in the modifiers field. Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley & Associates, Clearwater, Fla; and Raequell Duran, president of Practice Solutions, Santa Barbara, Calif.
Mississippi Subscriber
Tactic: Check with your software company and your carrier to see if you can report all four modifiers instead of appending modifier -99. If so, report 66984-79-54-QB-LT (Extracapsular cataract removal with insertion of intraocular lens prosthesis, manual or mechanical technique; unrelated procedure or service by the same physician during the postoperative period; surgical care only; physician providing service in a rural HPSA; left eye).
Another way: Bill 66984-99 and list "-79-54-QB-LT" in the comments area or box 19.