Wiki Cataract Post OP glasses - Medicare

[hrensz]

Please bare with me as I am not sure how to exactly post this question. I am looking for input on the correct way to code and bill out for Post OP Cataract Glasses. I know for the extras we can bill with the GA modifier as long as we have the ABN form signed. With the frame we bill the V2020 but can we also bill the V2025 for a deluxe frame with the GA modifier? I am curious what a normal claim would look like billed out; example of codes would be V2020, V2025-GA, V2300-RT, V2300-LT, V2715(should this code be broken down into 2 lines with the RT & LT modifier; or can it be on one line with both RT & LT, V2781-GA-RT, V2781-GA-LT, V2784-GA-RT-LT, V2750-GA-RT-LT. Thanks in advance for any and help and advice.

 

[sroe3314]

Medicare wants V2020 billed with the current allowable and then V2025 with the remainder of the noncovered amount. No modifiers are needed on V2025. V2300 and V2715 should be broken out to two lines with RT/LT if it is traditional DMERC, but advantage plans allow them on one line with RT and LT. The non covered items can go on a separate claim with modifiers EY, GA, RT, LT. Make sure to use POS 12 (Home) for Dmerc, Medicare Humana, and Medicare United Health Care. Hope this helps!