Wiki Conditions after Cat SX

TiffanyM101

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We have a patient that had cataract surgery then a week and a half later the patient developed iritis is that same eye. Am I able to bill an exam since its a new condition? Thank You.
 
If the documentation of the service indicates that this new condition is related to or is a complication of the surgery, then it is considered part of the global package and would not be separately billed. If the new condition is unrelated to the procedure, then it can be billed with a modifier 24. If the documentation is not clear as to whether or not it is related to the procedure, then you would need to query the provider for clarification.
 
Most cataract surgery patients have a certain level of anterior chamber inflammation, iritis, after surgery. If it got worse, then the patient's post op medications are most likely not controlling that inflammation adequately.
This is a problem covered by the 90 global period and the office visits for it are not billable during the 90 day period.

Tom Cheezum, OD,CPC, COPC
 
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