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Modifier?

Alea Posted Thu 09th of July, 2015 12:28:50 PM

CPT 65778, we have to repeat the procedure. It is within global. How do I bill this

SuperCoder Answered Fri 10th of July, 2015 00:47:59 AM

CPT code 65778 (Placement of amniotic membrane on the ocular surface; without sutures) has global period of 10 days. so you cannot bill the procedure again, until and unless it is required due to some complication or failure of graft. Use modifier -76 (Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional) or 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period) according to your case.

Alea Posted Sat 11th of July, 2015 21:31:03 PM

I gave you misinformation, patient had cataract surgery on 5/12/15, this amniotic membrane is the first procedure of this type we have to do for this gentleman. So would I need to use the modifier -79?

SuperCoder Answered Mon 13th of July, 2015 00:35:32 AM

CCI edits do not show any bundling issues between CPT 65778 and CPT codes for Cataract surgery. You can bill CPT 65778 without any modifier. Do not forget to append -LT/RT/Bilateral modifier as per your case.

Alea Posted Mon 13th of July, 2015 13:51:05 PM

Thank you so much!!

SuperCoder Answered Mon 13th of July, 2015 16:26:21 PM

You are welcome.

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