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How to code those complicated cataract surgeries – Ophthalmology Management

Cataract surgery is one of the most highly successful treatments in all medical history, with the cost-benefit equation to prove it. Further proof of my claim: Usually, all goes well.

But when the rare complicated surgery occurs, the proper coding for it may involve office visits, testing, and a major or minor surgical treatment; additionally, other providers are often involved, increasing the event’s coding complexity.

Another coding consideration: Some complications are intraoperative while others happen after discharge. If you want to obtain appropriate reimbursement, you will need to understand the relevant Medicare rules and regulations to ensure that you choose the correct codes. Most other payers follow Medicare rules, but they are not required to do so.

This article addresses the following topics:

  • Complications resulting in “devices or techniques not normally used”
  • Reimbursement for more than one surgeon
  • Groups and coverage

This article was published in Ophthalmology Management, and written by Corcoran’s Senior Consultant, Paul Larson, COE. To view the entire article in Ophthalmology Management, click on the link below:

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