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Permanent Lacrimal Punctum Plug Billing

 

Question: How to correctly bill Punctum Plugs?

Answer: CPT code 68761(closure of the lacrimal punctum; by plug,Punctum Plug each) should be used to report the lacrimal procedure. This procedure is based on per puncta, not per eye so in situations where two puncta are treated in the same eye, multiple surgery rules apply. So report each service as a separate line item, adding modifier-51 to the second and any subsequent procedure. If performed in both eyes, bilateral payment rules apply, so report this procedure code with a modifier-50. This code is same whether you used temporary( collagen) or permanent(silicone) plugs. Medicare does not allow separate reimbursement for the supply of the plug(s), however certain commercial payers do. Check with payers if the supply of the plug(s) are covered. If it is covered, report the supply codes with A4262[Temporary, absorbable lacrimal duct implant, each] or A4263[Permanent, long term, nondissolvable lacrimal duct implant, each].

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Comments

Please help. Patient has cataract SX and is within 90 day global. Patient comes back into the office and has 68761 performed. What would be the correct modifier to show this is within global but is unrelated to the cataract SX? Thanks.
Posted @ Saturday, June 25, 2011 9:00 AM by Jennifer
Dear Jen, 
 
Punctum plugs are inserted in the eyes to treat the dry eyes. Since you have mentioned that it is unrelated to cataract, you will need to put modifier-79 next to your CPT.Unrelated procedures are usually reported using a different ICD-9-CM diagnosis code. Also put modifier RT or LT (second place)after modifier 79.  
 
Posted @ Saturday, June 25, 2011 10:15 AM by Nidhi
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