OP NOTE: .....Vitrectomy instruments were placed inside the eye. The peripheral vitreous was shaved. Pick forceps were used and epiretinal membranes were peeled away from the puckered areas in the inferior mid periphery and inferior to the nerve and then an air/fluid exchange was carried out. Indocyanine green was dripped over the macular area. After a minute, it was removed. Balanced salt was placed back into the posterior pole. Under high magnification, the epiretinal membrane and internal limiting membrane were peeled away from the fovea region. There was an old retinotomy site above the superotemporal arcade and them membranes were amputated at the insertion site at the old retinotomy site. After the membranes were all peeled, the laser endoprobe was used and 498 laser burnes were placed, mostly in the inferior periphery over areas were the membranes previously were. After the laser was complete.....
QUESTION: This is for a commercial payer (NOT Medicare), Can
67042 vit with membrane peel and
67039vit with endolaser, be coded on the same claim? I know they are bundled with CCI edits, but again this is a commercial payer. I am audited quarterly by an outside audit company and they have contradicted themselves and mark me off for billing them together and for not billing them together to commercial payers. I have felt that
67042 is the more extensive procedure and usually bill for just that, but don't want to leave money on the table if I can bill
67039as well and recoup some of the money for the endolaser probe. Thanks for your help.