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Medicare Modifiers Used for Eye Surgery

Coding and billing professionals use modifiers to show that a procedure deviated from normal circumstances (but not enough to change the procedure definition or CPT code) and to secure appropriate payment. Here are some common eye surgery modifiers.

  1. Anesthesia Provided by a Surgeon

    • Many eye surgeries require only sedation or topical or regional anesthetic, which doesn't need to be administered by an anesthesiologist. When the ophthalmic surgeon does this, attach modifier --47.

    Surgeries on Both Eyes

    • Attach modifier --50 when a service has been provided bilaterally---that is, to both eyes during the same surgical session.

    Multiple Procedures

    • If a surgeon performs more than one discrete procedure during the surgical session, attach modifier --51 to procedures two through five.

    Deciding to Perform Surgery

    • Attach modifier --57 to the bill for the office visit during which the surgeon decided surgery would be performed.

    Need More Than One Modifier?

    • Attach modifier --99 if more than one modifier is necessary to fully describe what has taken place during the surgical session.

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