Wiki 66180 vs 0192T

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smcbroom

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what is the difference between the two codes 66180 & 0192T? is it payer specific or? I can see that Medicare reimburses higher for 0192T and this is a payer that reimburses a percentage of Medicare rates. Any insight would be greatly appreciated.

Thank you!
Susan, CPC-H
 
66180 is with a reservoir and 0192T is without reservoir. In researching these on the internet, I found some sites say to use 66180 whether a reservoir is used or not and some say not to and use 0192T(even some of the Medicare carriers are different in which code they accept!). Medicare does reimburse on the 0192T and that is what I use if the aqueous shunt is done without the reservoir.
Diann
 
I don't see where he specifically says he used a reservoir. Are the "key" words to look for in determining if a reservoir was used?

Thanks!
 
My surgeons usually state that a plate was inserted or the shunt was connected to the reservoir. I know one surgeon uses an Express shunt that is w/out a reservoir. I know it's a pain when you have to query them but I do if in doubt, but better to be safe than sorry!
Diann Do Bran CPC, CPC-H
 
that makes sense. He did the Express mini tube shunt so I will use 0192T correct?
 
The Xpress shunt is the 0192T. There is a limited list of dx codes that are covered. Think it is 365.11-365.15 or so. Sorry. I don't have the info here with me.
 
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