CPT Code 67335

CPT code 67335 is a medical billing code for suturing the iris during eye surgery.

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What is CPT Code 67335

CPT code 67335 is designated for the procedure of suturing the iris or the ciliary body during eye surgery. This code is used to bill for the specific surgical technique involving the placement of stitches in these parts of the eye, typically to repair damage or to correct structural issues that may affect vision.

Does CPT 67335 Need a Modifier?

For the CPT code 67335, which pertains to suture adjustment of an intraocular lens during surgery, several modifiers may be applicable depending on the specific circumstances of the procedure. Here’s an ordered list of potential modifiers and the reasons for their use:

1. -58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used if the suture adjustment is a planned, subsequent procedure that was staged or related to the initial surgery.

2. -78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period: Use this modifier if the suture adjustment was not planned at the time of the initial surgery and requires a return to the operating room.

3. -79 Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: This modifier should be applied if the suture adjustment is unrelated to the initial procedure and occurs during the postoperative period.

4. -76 Repeat Procedure by Same Physician: This modifier may be necessary if the suture adjustment needs to be repeated by the same physician, indicating that it is a separate instance of the same procedure.

5. -55 Postoperative Management Only: In cases where only the postoperative management of the suture adjustment is being handled by the physician (and not the actual procedure), this modifier would be appropriate.

6. -54 Surgical Care Only: If the physician is only responsible for the surgical portion of the suture adjustment and not the postoperative care, this modifier should be used.

7. -24 Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period: If an evaluation and management service is performed during the postoperative period for reasons unrelated to the original surgery, this modifier would be applicable.

Each of these modifiers serves to provide specific information about the nature of the service provided, helping to ensure accurate billing and appropriate reimbursement for the services rendered.

CPT Code 67335 Medicare Reimbursement

CPT code 67335, which pertains to suture adjustment of an intraocular lens during surgery, is a procedure that can be reimbursed by Medicare. However, the specific amount of reimbursement for this code can vary based on the geographic location of the service provider and the settings in which the procedure is performed (e.g., outpatient hospital, ambulatory surgical center, or physician's office).

To determine the exact reimbursement amount, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website. This schedule provides detailed information on the reimbursement rates for each CPT code based on the locality. Additionally, it's important for providers to verify that all conditions for reimbursement are met, including proper documentation and adherence to Medicare's coverage guidelines for the specific procedure.

Providers should also be aware that reimbursement rates are subject to change annually based on updates in Medicare policies and fee schedules. Therefore, regular checks on the CMS website or consultation with a healthcare revenue cycle management expert is recommended to stay updated on the latest reimbursement information for CPT code 67335.

Are You Being Underpaid for 67335 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize your contracts and identify discrepancies down to specific CPT codes, such as 67335 for eye suture during surgery, RevFind ensures that each service rendered is compensated correctly according to individual payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to, ensuring no detail, no matter how small, is overlooked.

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