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SLT / ALT Payment Indicator Fixed

On May 20, 2016, CMS released MLN Matters MM9633 detailing the July update to the Medicare Physician Fee Schedule. Included in this update is a revision to the bilateral indicator for CPT code 65855, laser trabeculoplasty. When published in January, the bilateral indicator was set at “2” which meant that this service was considered bilateral and would only be reimbursed once for both eyes. The update resets the bilateral indicator to “1” indicating that it can be reimbursed for each eye. If both eyes are lasered on the same day, modifier 50 applies and reimbursement is 150% of the allowed amount.

The change is retroactive to January 1, 2016. The transmittal indicates the following regarding claims paid inaccurately.

Note: MACs will not search their files to either retract payment for claims already paid or to retroactively pay claims. However, they will adjust claims brought to their attention.

The complete document can be found at: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9633.pdf

As always, if you need assistance, Corcoran Consulting Group can help. Visit our website or call us to learn more. You can link to our new App, Corcoran 24/7 via the links below.

 

www.corcoranccg.com (800) 399-6565

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