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vitrectomy and lens fragment removal after cataract surgery

Donna Posted Fri 25th of May, 2012 13:35:03 PM

Our Doc #1 did complicated cat surgery but left residual lens material behind. Patients IOP was high and not controllable with meds. Our Doc #2 went in did a pars plana vitrectomy and removed the lens material. Can you help me with modifiers. I have CPT codes 37036 and 66850.

SuperCoder Answered Fri 25th of May, 2012 17:25:45 PM

It seems both doctors are working as co surgeons here. Use modifer 62. Bill 67036-62 and 66850-62 together.

Documentation requirements for modifier 62
Additional reimbursement will be considered only when the documentation submitted clearly states the medical necessity of the co-surgery.
Each surgeon must document the separate procedures they are performing, or portions of procedures in individual op reports.
If multiple procedures are performed not all will necessarily meet the standard for co-surgery.
Billing must include the supporting documentation for use of modifier 62 versus modifier 80.

Donna Posted Fri 25th of May, 2012 17:56:57 PM

Sorry, I forgot to mention the surgeries were on different days.

SuperCoder Answered Fri 25th of May, 2012 18:46:30 PM

As Doc#1 did 688050 first which has a global period of 0 days and on the next day 67036 was performed by Doc#2(global period 90 days), there is no need of any postoperative modifiers. Modifier 77 is also not applicable since it is used on the same day or during the global period of the first service. The billing should be 67036 for Doc#2 and 68850 for Doc#1.The anatomic site modifier LT/RT would be applicable as appropriate.

Donna Posted Fri 25th of May, 2012 19:15:33 PM

Dr #1 did complete cat phaco with IOL implant. He used a Malyugen ring but had complication removing the cracked nucleus and left pieces behind. They waited a few days for the eye inflamation to go down and when they couldn't control the IOP, Dr #2 went in and did the 67036 and 66850. I'm not sure why Dr #1 inserted the lens with part of the nucleus left, but he did

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