comanagement

[jswjr1]

Does anyone know how to bill CMS for co-management of refractive surgery

[ezrich]

I would go to the Medicare website for your state. If your in Massachusetts, it would be National Heritage Insurance Co. Most of the medicare websites have up to date billing guides, tutorials, and seminars that you can participate online.

Im assuming you are billing Medicare for post-op after cataract surgery.

The normal post-op period is 90 days, starting the day of surgery. You must provide aleast one post-op exam or service before submitting your global charge for the remainder of the of the 90 day period.

When sending global claims to medicare, use the date of the surgury for the date of service, use the same procedure code (CPT) as the surgeon, along with a -55 modifier using RT or LT to indicate right or left eye.

On the cms 1500 form:

In box 17: Surgeon's name
In box 17b: Surgeons NPI
In box 19: Enter your post-op span date:
For eg: If patient had surgery on 06/19/08 and you saw him/her on 06/28/08. Enter in Box 19: Surgery RT 06/19/08 Post-Op 06/28/08 to 09/28/08.
In box 24a Date of Surgery
In box 24d Procedure or CPT code, modifier 55, surgery eye RT or LT
In box 24g number of global billing units/usually 1

I hope this helps, Im from Washington, so the billing rules may be alittle different in your state. But this is the basic idea.

[sharonm516]

In Kansas you also have to list the date for the 90th day as an end date...even if you only see them once in that 90 days. I hate billing Medicare..they want crazy information....:hammer: