MAR 11, 2024
Corneal Abrasion Noted Prior to Surgical Case
One of our surgeons performed cataract surgery and prior to beginning the surgery she noticed a corneal abrasion. When the patient came in for the one-day post-operative visit the surgeon wanted to place an amniotic membrane tissue. Would this be covered, or would it be part of the global package?Answer: If the corneal abrasion occurred prior to the surgery and not a result of the surgery, then it should be billable. Ensure that the documentation supports the unrelated medical necessity and link the appropriate diagnosis. The appropriate modifier to append for an unrelated procedure by the same surgeon during the global period is –79.
If the corneal abrasion occurred during the surgery, then it is considered part of the global surgical package.
Find additional education on global periods and modifiers in
Fundamentals of Ophthalmic Coding.