Daniel y Posted Tue 02nd of December, 2014 11:52:52 AM
One of our doctor performed pkp and other doctor performed Baerveldt valve and graft on same patient on same day. Can we get separate reimbursement? Which modifier do I need?
SuperCoder Answered Tue 02nd of December, 2014 16:01:13 PM
You would use modifier 78 or 79 on the second procedure depending on if the second procedure is related to the initial procedure that was performed.
Use 78 for an 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.
Use 79 unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period.
Hope this helps.
Daniel y Posted Tue 02nd of December, 2014 19:19:43 PM
On the same surgery day, a patient had corneal tissue transplant with one doctor with assistant surgeon and assistant surgeon performed glacoma implant by himself. Please let me there is any modifier I can use or is it possible to get reimbursement for both dr.
65755 80 RT
Do I need additional modifier?
Please let me know.
Daniel y Posted Wed 03rd of December, 2014 16:22:58 PM
Please someone answer my question.
SuperCoder Answered Fri 05th of December, 2014 07:04:24 AM
Thank your for your question.
Codes mentioned in your query are correct and no additional modifier is needed to bill codes for both Surgeons.
Dr 1 will bill 65755 for penetrating keratoplasty.
Dr 2 (Assistant Surgeon) will append 80 with 65755 for claiming Assistant surgeon fees during the procedure.
Since Surgeon 2 also performed 66180 and 67255 as stand alone primary surgeon, he can bill for them without modifier 80.
Modifier RT/LT would be used by both the providers to indicate the side of eye on which the procedure was performed.
Also, When more than one surgeon acts as a primary surgeon for multiple procedures during the same operative session, the services of each may be covered.
Hope it helps!
Daniel y Posted Fri 05th of December, 2014 12:32:57 PM
SuperCoder Answered Sat 06th of December, 2014 12:44:32 PM