Wiki IOL master denials

[juliagreen1968@gmail.com]

We have been having trouble with Coventry and Medicare denying code 92136. With Coventry the first eye is billed with no modifier, second eye with modifiers 52 and the eye performed on. Medicare is being billed with the eye being performed on for the first eye, and modifier 26 with the second eye being done. This has always been paid in the past. Any suggestions?
Thank you!!!!

 

[smarcolina]

We bill Medicare as well as Coventry and have not had any issues with payment.
92136-TC
92136-26-50

 

[jareardon]

We bill the same for Medicare and Coventry

First eye 92136 dx indicates bilateral
Second eye 92136-26 dx indicates which eye

If second eye is done more than 12 months after the first, a repeat biometry is medically necessary so bill globally (no modifiers).