Ophthalmology

[slicon]

I have a question regarding billing for cataract surgery PreOps. We have always billed 92136 which is the IOL measuring for the correct lense for the eye. It has come to my attention that it may be possible to bill an intermediate visit (92012) along with the 92136 in the same claim. Is this justifiable by Medicare?




UPDATE: For State of New Mexico-- Medicare guidelines for cataract surgery only allow for one visit to be billed (being the cataract consult of some sort before scheduling). Although the two codes are payable together-- it wouldn't suffice through an audit for all of our cataract situations.

[kristin]

Have you researched LCD/NCD's for your MAC for that code?

[Michele]

If the provider feels a 92012 is warranted then it should be billed.  If the insurance doesn't allow it on the same day then they will bundle or deny.  I do believe it is allowed together though, as long as the notes support the services billed.