Wiki 66821 - Yag Cap

[karriedemas@yahoo.com]

Patient was referred by another doctor to have a yag cap performed on both eyes and the follow is being done by the referral provider. The doctor performed the yag cap on both eyes on the same day. Here is how I coded this but it's getting rejected by PA Medicare for frequency of services.

66821 54,RT
66821 54,LT

Please let me know what I'm doing wrong - Thanks

 

[stacigadsby]

my best initial guess is that you need to either bill it as bilat or add a mod 79 to the second line

 

[mzkandyd]

Why are you billing with a 54 modifier? Is this a co-management? You don't co-manage YAGs. Was this YAG performed AFTER the cataract surgery?

Please let me know so I can help you. There are 2 possible scenarios, but I need to know if there was a cataract surgery performed in the last 90 days.

Ok to message me offline if need be.

 

[erinmiller]

Our Ga Medicare doesn't like 2 lines for yags. I usually bill it with 1 line and add 50 mod for bilateral.

66821 - 54, 50