CPT code 65771 is a medical billing code for the surgical procedure known as radial keratotomy, used to correct vision.
CPT code 65771 is designated for the surgical procedure known as radial keratotomy. This procedure involves making spoke-like incisions in the cornea to correct refractive errors, primarily myopia (nearsightedness). The goal is to flatten the cornea to improve the focusing power of the eye.
For CPT code 65771 (Radial keratotomy), the application of modifiers depends on specific circumstances surrounding the procedure. Here’s an ordered list of potential modifiers that might be applicable and the reasons for their use:
1. -LT (Left side) and -RT (Right side): These modifiers are used to specify which eye underwent the radial keratotomy, as procedures on the eyes often require specification of laterality.
2. -50 (Bilateral procedure): If radial keratotomy is performed on both eyes during the same surgical session, this modifier should be used to indicate a bilateral procedure.
3. -22 (Increased procedural services): This modifier may be necessary if the procedure requires significantly more effort or time than typically required, due to specific patient conditions or complications.
4. -52 (Reduced services): If the procedure is partially reduced or eliminated at the physician's discretion, this modifier would be appropriate.
5. -79 (Unrelated procedure or service by the same physician during the postoperative period): If radial keratotomy is performed during the postoperative period of another unrelated procedure, and the procedures are performed by the same physician, this modifier would be used.
6. -24 (Unrelated evaluation and management service by the same physician during a postoperative period): This is applicable if an evaluation and management service is performed during the postoperative period of the radial keratotomy that is unrelated to the original procedure.
7. -59 (Distinct procedural service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
Each of these modifiers addresses specific billing and procedural nuances that may arise during the administration of radial keratotomy, ensuring accurate and precise claims processing.
Radial keratotomy, represented by CPT code 65771, is a surgical procedure used to correct myopia (nearsightedness) by making spoke-like incisions in the cornea to flatten it and improve the eye's focusing ability. However, it's important to note that Medicare generally does not cover radial keratotomy. This decision is based on the classification of the procedure as elective and primarily for cosmetic purposes, which are not typically covered under Medicare's guidelines.
Since Medicare does not reimburse for CPT code 65771, there is no standard reimbursement amount associated with this procedure for Medicare patients. Healthcare providers performing this procedure on Medicare beneficiaries typically need to ensure that patients are aware of their financial responsibility and may consider having them sign an Advance Beneficiary Notice (ABN) to acknowledge that they understand the procedure is not covered and agree to pay out-of-pocket.
For healthcare providers, it's crucial to stay updated with Medicare coverage policies and ensure clear communication with patients regarding the coverage and costs of procedures like radial keratotomy.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize your contracts and identify discrepancies down to specific CPT codes, such as 65771 for radial keratotomy, RevFind ensures that each claim is fully compensated according to the terms agreed with individual payers. Schedule a demo today to see how RevFind can safeguard your earnings and streamline your billing processes.
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