Medicare Rules for Multiple Procedures – Ophthalmology Management

Medicare has specific rules that affect the payment when multiple surgical procedures are performed at the same session. Some of these rules are not well understood or appreciated. Let me try to provide some clarity.

This article answers the following questions:

  • What is Medicare’s multiple surgery rule?
  • Does a payment reduction also apply to bilateral procedures?
  • How do we report procedures that are both multiple and bilateral?
  • If two surgeons in the same group practice perform procedures at the same operative session, what is the effect on Medicare payment?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:

http://www.ophmanagement.com/article.aspx?article=105609

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