Wiki 66984

[jbmedbilling]

I am having trouble getting medicare to pay for POS 11 for 66984. My other payers have no problem paying both POS 11 and 24, but I haven't figured out the magic combination to get the professional services paid. Any thoughts?

 

[dkeown]

I am having trouble getting medicare to pay for POS 11 for 66984. My other payers have no problem paying both POS 11 and 24, but I haven't figured out the magic combination to get the professional services paid. Any thoughts?

Well, all my providers use an ambulatory surgery center or hospital operating room for their cataract surgeries, so not sure which payers are allowing cataract surgery in an office setting.

David E. Keown, CPC, OCS

 

[kebooe@yahoo.com]

Our provider wants to start doing the cataracts in the office? Do you know what carriers pay for it in the office setting and which do not?

 

[Cheezum51]

I'm not sure what you mean by "in the office setting." Is there an approved OR/ASC located within the office? If not, then your provider will have to get the necessary state and local health department approvals for the facility and, most likely, some carriers may actually want to inspect the facility before they will agree to pay for services offered there.

Tom Cheezum, OD, CPC, COPC

 

[KFOX8408]

Does your provider co-manage with an ophthalmologist/surgeon? If so, you can use POS 11 with 66984-55-LT/RT for the first eye, and 66984-55-79-LT/RT for the second eye and make sure the dates (from sx date to the relinquished date) are the same as the ophthalmologist/surgeon. This is only for post-op care only.