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Office Codes and Metallic FB

Lovell Posted Tue 09th of July, 2013 12:54:23 PM

Can you bill an Office Services Code '92014,99212' and metallic FB procedure code '65222' if the reason for the patient's pain is an obvious metallic FB or should we just bill the metallic FB procedure code alone?

SuperCoder Answered Tue 09th of July, 2013 23:58:11 PM

Yes.Use the CPT code 65222 (removal of foreign body, external eye: corneal, with slit lamp) when removing one or more foreign bodies. Unfortunately, there's no other code or modifier that allows you to collect more for the additional work involved in removing multiple foreign bodies. When submitting a claim for an E/M service on the same day as the foreign body removal, you should use the modifier -25 on the office visit code so that you'll be paid for both services.

Medicare does examine frequency issues. If you're following a patient more frequently, you're probably assessing a chronic medical ocular condition (e.g., glaucoma, glaucoma suspect, allergic conjunctivitis, etc.). These encounters may be more accurately described by an E/M service (for example, 99212 or 99213) rather than by a comprehensive exam code (92014).

When you code for a comprehensive exam (92014), you must always initiate new diagnostic or treatment programs. If you use the same 92014 CPT code and the same ICD-9 code repetitively, there's a risk of denial of payment for frequency and an audit risk for failing to initiate a new diagnosis or treatment plans.

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