Wiki modifier - medicare require

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Sdavenport

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which modifier does medicare require for procedure 92286? They denied RT and LT.

Thanks
Sheila,
WEA
 
Here's what my EncoderPro says: "This code has been revised for 2013 in the official CPT description. This is a unilateral procedure. If performed bilaterally, some payers require that the service be reported twice with modifier 50 appended to the second code while others require identification of the service only once with modifier 50 appended. Check with individual payers."

Good luck!
 
Thank you for the information!! I am new to coding optometry so any advice will be very much appreciated!!!!
 
www.encoderpro.com

This is a service my employers pay for (I think it's pretty expensive) and is a quick way to view all sorts of info about a given code. For coding per se, I don't like it as well as my books, but for things like NCCI edits and LCDs, it's all at your fingertips.

Welcome to the world of optometry coding, by the way! :)
 
Sorry for the delay and for getting back to me. I want to do a good job and code and bill smart. Does your office bill for both e/m codes and eye codes? I recentlyl read that the e/m codes have a higher reimbursement.
 
For medical office visits, we will use either E/M or eye codes depending on the situation and the payer (some payers don't like eye codes with a primary medical diagnosis). 920x4 is usually very well reimbursed, if the visit qualifies, and the documentation requirements aren't quite as strict as the E/M codes. My doctors' documentation doesn't usually qualify for much more than a level 3 E/M. If your provider is better at documentation, you might get more level 4s. I would pull the fee schedules for the major carriers in your area and compare that way.

Hope this helps!
 
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