Wiki 67145 session billing - HELP!!!

[mamor]

Patient had PRP, code 67145 -LT for a retinal hole at the 2:00 position on 5/13; pt returned on 6/10 with a horseshoe tear -LT at the 11:00 position and retreated. Code 67145 includes ONE or MORE sessions same eye, however I am being told by my boss to append the 2nd treatment with -79. Help.

 

[indrani]

Try with mod 59 to indicate different position, along with mod 79. also, dx is different, so the payer may pay for the second session. it would be best to submit this claim with sx report. thanks

 

[heatherlee777]

Anyone having issues with diagnosis codes H33.312 and H354.11, basically for opposite eyes on same claim being denied by any payers and if so, what is the fix? How do you identify what the payer wants to verify opposite eye diagnoses?

diagnosis codes, diagnosis coding

 

[TThivierge]

Hi
Did you use eye modifier RT or LT and or E1-E4 Anatomic modifiers which are associated with the eyelid Description : E1 Upper left, eyelid E2 Lower left, eyelid E3 Upper right, eyelid E4 Lower right, eyelid ? This might help your claim
Lady T

diagnosis codes, diagnosis coding