Ophthalmology and Optometry Coding Alert
Bill Post-Trabeculectomy 5-FU Supply, Not Injection
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).
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Bill Post-Trabeculectomy 5-FU Supply, Not Injection
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