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Issue Number - Name
0084 - Cataract Removal Excessive Units (Full)
Review Type
Automated
Claim Type
Professional Services (Physician/Non-Physician; Outpatient Hospital; Ambulatory Surgery Center)
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 will be denied. This new issue indicates that findings are across claims, for the same eye, and the finding claim line is a full recovery.

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