JUL 15, 2022
Provider Sees Patient for Two Exams Same Day
Question: We saw a new patient in the morning for a complete eye exam. The patient came back that afternoon with acute angle closure. The patient was treated in the office for over an hour with multiple doses of eye drops. The patient returned the next day for a laser PI. Can we bill for both exams on the same day? Do either require a modifier because laser was performed the next day?
Answer: If a provider sees the patient twice on the same day, it is appropriate to combine the work performed for the two visits and select a single evaluation and management (E/M) service code that best describes the combined service. Confirm payer’s global period for CPT code 66761, Iridotomy/iridectomy by laser surgery. If they recognize it as a 10-day global period, then no modifier is necessary for the office visit code. If the global period per the payer is 90 days, then append modifier –57 to the office visit code. The chart documentation should include the order for the emergency procedure scheduled for the next day.
Additional coding competency resources can be found in
Fundamentals of Ophthalmic Coding.