Wiki 67036-vitrectomy, 66986-IOL exchange and 66682- suture IOL

[cupcake85233@gmail.com]

I am trying to bill 67036, 66986 and 66682 for a patient who had a dislocated IOL (a sutured IOL was placed). I followed AAO guide and billed but the claim was suspended by the clearinghouse. Would the suspension be due to the displaced IOL diagnosis code and not the procedure codes? I mentioned this to our Physician, but he felt that the 3 codes should be billed.

 

[natashalage]

hello,
I am not an expert but here are my thoughts. All 3 cpt are allowed per NCCI but 66682 Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, McCannel suture)- is a Separate procedure. I was told not to bill CPT if it's a separate procedure (general rule)