Ophthalmology and Optometry Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer. Question: We had a Medicare patient present one week after undergoing a trabeculectomy now with vascularization of a bleb. The ophthalmologist performed a 5-FU injection. Is this billable? Texas Subscriber    
  Answer: Billing postoperative injections can be tricky because injections have both a procedural code and a supply code. Because the vascularization of the bleb was a complication of the trabeculectomy and was handled in the office, it is considered included in the global surgical package of the trabeculectomy. But just because you can't bill for the injection of the 5-FU doesn't mean you can't bill for the supply of the medicine. You should bill the medicine using HCPCS code J9190 (Fluorouracil, 500 mg). If the physician had planned to perform the injection(s) and stated so in the operative report, then the service of the injection (and the injectable) could have been billed with modifier -58 (Staged or related procedure or service by the same physician during the postoperative period).