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67028 c 66170 & 66984

Shamae Posted Tue 28th of April, 2020 13:40:10 PM
As an ASC can we bill for 67028- Avastatin given intraoperatively? And if so, what is the correct way to bill that with procedures 66170 & 66984
SuperCoder Answered Wed 29th of April, 2020 06:58:24 AM

Hi Shamae,


Thanks for your question.


The descriptor for code 67028 indicates that the procedure is a separate procedure and should not be reported when performed along with a related procedure (e.g., same anatomic area or through the same incision, orifice, or surgical approach).


Moreover, code 67028 has CCI edit with code 66984 and code 67028 is a column 2 code for 66984. So, you should not report code 67028 for the procedure performed on the same eye. You may use a CCI-associated modifier to override the edit only under appropriate circumstances (e.g. if procedures are performed on different eyes).


Please feel free to write if you have any question.



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