(CPT 66984-54 and 66984-55)
The Alliance has identified inconsistent billing of post-operative management for cataract patients, particularly when the surgeon and optometrist both care for the patient during the post-operative period. The Alliance recommends that providers follow CMS billing guidelines, including supplying the number of days of care in the “units” field of the CMS-1500 claim. Following these guidelines will allow The Alliance to reprice each provider’s claim according to how much of the post-operative care was provided by each provider.
The Alliance has prepared billing guidance on this topic on the About Claims page.