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Issue Number - Name
0083 - Cataract Removal Excessive Units (Partial)
Review Type
Automated
Claim Type
Professional Services (Physician/Non-Physician ; Outpatient Hospital
Region and State
RAC 1-4
All States
Date Approved
2018-02-13

Description

Cataract removal cannot be performed more than once on the same eye on the same date of service. Providers billing for more than one unit of cataract removal for the same eye, on the same claim line, will be denied. The New Issue indicates the finding is billed on the same claim line with units greater than 1 (for the same eye). The provider is entitled to payment for one eye and only a partial payment will be recovered.

Affected Code(s)

  • CPT 66830, 66840, 66850, 66852, 66920, 66930, 66940, 66982, 66983, 66984

Applicable Policy References

  • Title XVIII of the Social Security Act, Section 1833
  • Title XVIII of the Social Security Act, Section 1862(a)(1)(A)
  • National Correct Coding Initiative Policy Manual, Chapter 8, Section D