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Posted By Amanda on 05-13-2002, 13:28:00 in Ophthalmology
How do you bill 68840 when done on both eyes? In the Medicare book it shows
that this codes can't be billed with the modifier 50.

Thanks!

Amanda
Comments (4)
Posted By michael on 05-16-2002, 01:37:00

In a message dated 5/14/02 3:36:08 PM, tbarrett@carolinaeyes.com writes:

<< I CHECKED MY CPT CODE BOOK AND 68840 IS NOT LISTED AS BILATERAL OR
UNILATERAL. I WOULD CODE 68840RT THEN 68840LT. GOOD LUCK! which
medicare book do you use?

terri
>>

Well, since there are 4 channels, one for each lid, I find it easier to
designate which ones were done by using the lid specific E codes.

Dr. Yaros
Posted By terri on 05-14-2002, 17:40:00
I CHECKED MY CPT CODE BOOK AND 68840 IS NOT LISTED AS BILATERAL OR
UNILATERAL. I WOULD CODE 68840RT THEN 68840LT. GOOD LUCK! which
medicare book do you use?

terri
Posted By douglas on 05-14-2002, 11:14:00
I see Brian's point, so my previous answer (that you probably always do
68840 on both sides, like a refraction) may be wrong, assuming you are
correct about 68810-15. The only thing I can see is that 68810 may indeed
be done unilaterally on a symptomatic, troublesome side, and would be done
twice if both sides are bothersome. Maybe indeed 68840 is usually done on
both sides.

In the end, I guess it depends on how the relative values were set. If they
were set based on the time, effort, expertise, etc., for one side, then you
can add a -50. If the value was set on the assumption that usually both
sides are done, then a -50 would be inappropriate. Without knowing that, I
guess you can't really know the answer to the question. However, if the
rule book says you can add a -50 for one thing but not another, I would
assume that somewhere it is defined that the service or its value is
unilateral or bilateral, and you can use a -50 only if it had been defined
or valued as unilateral.

So, who knows?
Posted By douglas on 05-13-2002, 17:06:00
"can't be billed with the modifier 50." because like refraction, it is
assumed you always do both eyes, I think.
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