CPT code 66700 is used for billing the destruction of the ciliary body, typically to treat glaucoma.
CPT code 66700 is used to denote a medical procedure involving the destruction of the ciliary body. This procedure is typically performed to treat conditions such as glaucoma by reducing the production of aqueous humor, thereby lowering intraocular pressure. The destruction can be achieved through various methods, including laser or cryotherapy.
For CPT code 66700, which refers to the destruction of the ciliary body, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is an ordered list of potential modifiers and the reasons for their use:
1. -LT (Left side) and -RT (Right side): These modifiers are used to specify which eye underwent the procedure, as the ciliary body destruction can be unilateral.
2. -50 (Bilateral procedure): If the procedure is performed on both eyes during the same operative session, this modifier should be used to indicate a bilateral procedure.
3. -22 (Increased procedural services): This modifier is used when the work required to perform the procedure is substantially greater than typically required. Documentation must support the extra work and the reason for it.
4. -52 (Reduced services): If the procedure is partially reduced or eliminated at the physician's discretion, this modifier should be applied to indicate that the service is less than the usual.
5. -59 (Distinct procedural service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. It is crucial for avoiding bundling issues and ensuring proper reimbursement.
6. -51 (Multiple procedures): Used if multiple procedures are performed during the same surgical session, this modifier helps in adjusting the reimbursement rates for the additional procedures.
7. -79 (Unrelated procedure or service by the same physician during the postoperative period): This modifier is applicable if the destruction of the ciliary body is performed during the postoperative period of another unrelated procedure, and it is not a complication of the first procedure.
8. -24 (Unrelated evaluation and management service by the same physician during a postoperative period): If an evaluation and management service is performed during the postoperative period for a reason unrelated to the original procedure, this modifier would be necessary.
Each of these modifiers serves to provide specific details that can affect billing and reimbursement, ensuring that the healthcare provider's billing is accurate and compliant with payer requirements. Proper documentation and justification for each modifier are essential for appropriate payment and audit-proofing the claims.
CPT code 66700, which refers to the destruction of the ciliary body, is typically reimbursed by Medicare. However, the exact reimbursement amount can vary based on several factors including the geographic location of the service provider, the setting in which the procedure is performed (such as inpatient, outpatient, office), and the Medicare Administrative Contractor (MAC) policies for that region.
To determine the specific reimbursement amount for CPT code 66700, healthcare providers should consult the Medicare Physician Fee Schedule (MPFS) lookup tool available on the Centers for Medicare & Medicaid Services (CMS) website. This tool provides detailed information about the reimbursement rates for specific procedures based on the provider's locality. Additionally, providers should verify coverage and payment details with their local MAC to ensure compliance with any regional policies or guidelines that may affect reimbursement for this procedure.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize contracts and identify discrepancies down to specific CPT codes, such as 66700 for the destruction of the ciliary body, RevFind ensures that each service rendered is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can secure the payments you are entitled to for every procedure, including individual payer details.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
