Ophthalmology and Optometry Coding Alert

Reader Questions:

Save S0800 for Non-Medicare Carriers

Question: What code should we use for LASIK?


North Dakota Subscriber
Answer: Because there is no CPT code for laser-in-situ keratomileusis (LASIK), report 66999 (Unlisted procedure, anterior segment of eye) for Medicare carriers. Non-Medicare carriers may accept HCPCS code S0800 (Laser in situ keratomileusis).

Even though Medicare and some other insurers typically will not cover LASIK to correct refractive error or other refractive procedures such as radial keratotomy (RK), conductive keratoplasty (CK) and intrastromal corneal ring segments (Intacs), you may need to submit a claim to Medicare to obtain a denial so the patient can seek reimbursement elsewhere.

To keep your records complete, or to prompt denials from Medicare or other carriers, report these refractive procedures as follows:

• RK: Report 65771 (Radial keratotomy).
• Conductive keratoplasty: Report 66999.
• Intacs: Report temporary Category III code 0099T (Implantation of intrastromal corneal ring segments). Do not report 66999--CPT rules direct that if a Category III code is available, you must report it instead of an unlisted-procedure code.
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