Laser cataract coding and billing – Ophthalmic Professional

The process of coding and obtaining proper reimbursement for laser cataract surgery is complex enough to warrant a two-part article. In this first part, we focus on a simple question with a complex answer. The question: Who pays for the surgery and associated testing if we use the femtosecond laser in cataract surgery?

Insurance companies pay a fixed, negotiated rate for a “package of services” that includes:

  • Some preoperative work.
  • The actual surgery to remove the lens and replace it with an IOL.
  • Basic postoperative care.

The monofocal IOL and the viscoelastics are part of this package. Injections, drops, and supplies, such as the infusion solution and tubing, are also part of this payer package. Payers refer to this as the “global surgery package.”

This article addresses the following topics:

  • Use of a femtosecond laser
  • Covered and non-covered services

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

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