How should our freestanding ASC cipher and bill for the new technology intraocular lenses (NTIOLs) that are acceptable for a $50 acquittal acclimation from Medicare?
Starting May 18, 2000, you can get an added $50 back application the afterward two lenses: – The Allergan AMO Array Multifocal Model SA40N. Use HCPCS cipher Q1001. – The STAAR Surgical Elastic Ultraviolet-Absorbing Silicone Posterior Chamber IOLs, models AA4203T, AA4203TF and AA4203TL. Use HCPCS cipher Q1002.
To accept the added payment, address the HCPCS cipher with one of the afterward CPT codes for avalanche abstraction surgery:
66983. Intracapsular avalanche abstraction with admittance of intraocular lens prosthesis (one date procedure) – ASC Acquittal Group 8.
66984. Extracapsular avalanche abatement with admittance of IOL (one date procedure), chiral or automated address (e.g., irrigation and aspiration or phaco) – ASC Acquittal Group 8.
66985. Admittance of IOL (secondary implant), not associated with circumstantial avalanche abatement – ASC Acquittal Group 6.
66986. Exchange of intraocular lens – ASC Acquittal Group 6.
Medicare will pay a collapsed $50 exceptional over and aloft the $150 acquittal allowance already included in the ASC ability fee for a accepted IOL.
Fill out the HCFA-1500 affirmation anatomy as follows: In Box 24B (Place of Service) address “24” for ambulant anaplasty center. In Box 24C (Type of Service) address “F” for ambulant anaplasty centermost ability service.
Bill application two band items in box 24D. One band account charge appearance a avalanche abstraction CPT cipher – 66983, 66984, 66985, or 66986 – whichever appropriately describes the action performed. A additional band account charge appearance the actual Q cipher for the Medicare accustomed NTIOL. Medicare will again balance you the added $50, accountable to coinsurance and deductible.
The modifier “SG,” which ensures that claims for ASC ability casework are paid beneath the ASC Acquittal Groups 1-8, charge additionally arise in box 24D on the HCFA-1500 form.
Note that if you abide a HCFA-1500 affirmation to your Medicare carrier absolute alone a Q cipher for the NTIOL, the carrier will attention the affirmation as abridged and will acknowledgment it to you as unprocessable.
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