CPT Code 65770

CPT code 65770 is for a surgical procedure to revise the cornea using an implant.

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What is CPT Code 65770

CPT code 65770 is designated for a surgical procedure involving the revision of the cornea with the insertion of an implant. This code is used specifically when a surgeon performs a keratoplasty procedure, which involves reshaping the cornea by inserting a corneal implant to correct issues such as keratoconus or other corneal deformities. This procedure aims to improve the cornea's shape and function, enhancing the patient's visual acuity.

Does CPT 65770 Need a Modifier?

For the CPT code 65770, which pertains to the surgical procedure of revising the cornea with an implant, several modifiers may be applicable depending on the specific circumstances of the surgery and billing context. Here is an ordered list of potential modifiers and the reasons for their use:

1. -22 (Increased Procedural Services): This modifier is used when the work required to perform the surgery is substantially greater than typically required. This could be due to extensive scar tissue or other complications.

2. -51 (Multiple Procedures): Use this modifier if this procedure is performed at the same time as one or more additional procedures. It indicates that multiple procedures were performed during the same surgical session.

3. -52 (Reduced Services): If the procedure is partially reduced or eliminated at the physician's discretion, this modifier should be applied to indicate that a service or procedure was partially reduced or eliminated.

4. -53 (Discontinued Procedure): Applied when a surgical or diagnostic procedure is terminated after the beginning but before completion due to extenuating circumstances or those that threaten the well-being of the patient.

5. -54 (Surgical Care Only): When one physician performs a surgical procedure and another provides preoperative and/or postoperative management, this modifier is used by the surgeon.

6. -55 (Postoperative Management Only): Used by a physician who provides postoperative management but did not perform the surgical procedure.

7. -56 (Preoperative Management Only): Used when one physician performed the preoperative care and evaluation and another performed the surgery.

8. -58 (Staged or Related Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when a staged or related procedure is performed during the postoperative period of the initial procedure.

9. -59 (Distinct Procedural Service): Indicates that procedures that are normally bundled into one payment were performed in separate and distinct circumstances, warranting additional reimbursement.

10. -78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): This modifier is used when a return to the operating room is required to address a complication from the initial procedure.

11. -79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Used when an unrelated procedure is performed by the same physician during the postoperative period of the previous procedure.

12. -LT (Left Side) and -RT (Right Side): These modifiers are used to specify which eye the procedure was performed on, which is critical for procedures involving organs that come in pairs.

Each of these modifiers addresses specific circumstances that might affect how the procedure is billed and reimbursed, ensuring accurate and fair compensation for the services provided.

CPT Code 65770 Medicare Reimbursement

CPT code 65770, which pertains to the surgical procedure of revising the cornea with an implant, is generally reimbursed by Medicare. However, the specific amount of reimbursement can vary based on geographic location, the facility where the procedure is performed, and other factors. To determine the exact reimbursement rate, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website or through your Medicare Administrative Contractor (MAC). This will provide the most accurate and up-to-date information regarding reimbursement for this particular procedure.

Are You Being Underpaid for 65770 CPT Code?

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 65770 for revising the cornea with an implant, RevFind ensures that each claim is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to for every procedure billed.

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