tci Outpatient Facility Coding Alert - 2013 Issue 7

Reader Question: Return for Bleb Needling Is Reportable With 66250

Question:  The ophthalmologist performed a needling procedure during the postoperative period of a trabeculectomy to lower a patient’s IOP (intraocular pressure). Can I bill the needling procedure separately or is it considered included because it falls under the trabeculectomy’s global surgical package? West Virginia Subscriber Answer: Payers consider most related services that an ophthalmologist performs in the postoperative period to be included in the initial procedure, and therefore not separately billable. But because the ophthalmologist performed this procedure for a complication of the initial procedure, it may be separately billable — it all depends on where the...

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