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Optometry Coding & Billing Alert

You Be the Expert:

Know Your Bilateral Rules

Question: Our patient was working on a building demolition and ended up with small pieces of debris in both eyes. How should we code the double foreign body removal? Subscriber

Answer: If you remove foreign bodies from the right cornea and the left cornea, report both removals -- report 65222-RT (Removal of foreign body, external eye; corneal, with slit lamp, Right side) and 65222-LT (Left side), or 65222-50 (Bilateral procedure).

Medicare payers will reimburse 150 percent of the fee schedule amount for 65222 performed bilaterally. Based on the 2016 fee schedule, 65222 performed unilaterally should reimburse $67.31 (before geographic adjustments are factored in). Claiming 65222-50 should yield $100.96.