Wiki Cataract Surgery and use of Femtosecond Laser

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tmankins

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Our eye surgeons are using a Femtosecond laser to implant an IOL during cataract surgery. CMS Rulings 05-01 and 1536-R state we can bill the patient the cost of the laser. Does anyone else use the laser to implant IOL and charge the patient for the additional cost of using the laser and if so, how do you bill the claim to Medicare to show what the patient is paying for the non-covered part?
 
Our office does not bill the extra. You can bill the extra, but if you do, Medicare will not cover that, so you will need to make sure you go over the premium pricing with the patient and have them sign an ABN/NEMB to make sure they understand that the service they are receiving is above and beyond what Medicare will deem as medically necessary. You could handle it the same way you would handle a premium lens.
 
The patients are aware and they agree to pay the additional costs of the laser. Do you add the additional costs to the cost of the lens and use V2787?
 
We bill the patient the cost of the laser and do not submit to insurance. The patient signs consents beforehand when selecting the lens/femto acknowledging they will pay for it and it will not be billed to Medicare. Since we don't submit it, we made up a code just for our billing software so the monies are applied to their account.
 
Our offices bills the laser as a "premium" service because it was elected by the patient. We do not bill those to Medicare, I have it setup to flag it as "self-pay" in my PM system.
 
billing Femtosecond laser

Has anyone billed Femtosecond laser to Medicare? just to please a patient? If so, what code did you use?

Thank you!

Layla
 
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