CPT Code 66183

CPT code 66183 is for the insertion of an anterior segment drainage device without extraocular reservoir.

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What is CPT Code 66183

CPT code 66183 is used to denote a medical procedure where an aqueous drainage device is inserted into the eye. This procedure is typically performed to help manage intraocular pressure in patients with glaucoma, where other treatments may not have been effective. The device helps to facilitate the drainage of aqueous fluid, thereby helping to control the pressure within the eye.

Does CPT 66183 Need a Modifier?

For CPT code 66183, which pertains to the insertion of an anterior segment aqueous drainage device, without extraocular reservoir; external approach, 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. -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 increased complexity or complications encountered during the procedure.

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 on the same day.

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 procedure is terminated due to unforeseen circumstances which may compromise the well-being of the patient.

5. -54 (Surgical Care Only): This modifier is used when one physician performs a surgical procedure and another provides preoperative and/or postoperative management.

6. -55 (Postoperative Management Only): Used when one physician performs the postoperative management and another physician performed the surgical procedure.

7. -56 (Preoperative Management Only): Indicates that a physician performed the preoperative care and evaluation prior to surgery, but did not perform 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 sessions or patient encounters.

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 second procedure is performed as an unplanned return to the operating room after the initial procedure, due to complications.

11. -79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Used when a procedure performed during the postoperative period is unrelated to the original procedure.

12. -80 (Assistant Surgeon): Used when an assistant surgeon is present to help the primary surgeon during the procedure.

13. -AS (Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery): This modifier is used specifically for non-physician practitioners who assist at surgery.

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

Each of these modifiers provides specific information that can affect billing and reimbursement, and their correct application is crucial for accurate healthcare revenue cycle management.

CPT Code 66183 Medicare Reimbursement

CPT code 66183, which refers to the insertion of an anterior segment aqueous drainage device without extraocular reservoir, external approach, is typically reimbursed by Medicare. However, the specific amount of reimbursement can vary based on the geographic location and the setting in which the procedure is performed (e.g., outpatient hospital, ambulatory surgical center, or physician's office).

To determine the exact reimbursement amount, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website or through Medicare Administrative Contractors (MACs) that manage claims and payments in specific regions. These resources provide detailed information on the reimbursement rates applicable to different procedural settings and geographic adjustments.

Are You Being Underpaid for 66183 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 66183 for the insertion of an anterior drainage device, 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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