Health Information Management

Q/A: Coding for telescopic intraocular lens

APCs Insider, February 10, 2012

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Q: An ophthalmologist implanted a telescopic intraocular lens (C1840) that is supposed to be separately payable. Our FI/MAC didn’t pay us and said it processed the claim correctly. Do you have any information about this situation?

A: CMS established new HCPCS code C9732 (insertion of ocular telescope prosthesis including removal of crystalline lens) for calendar year 2012.

According to Transmittal 2386 (January update to OPPS), HCPCS code C1840 (lens, intraocular [telescopic]) is a pass-through category and is separately payable only when reported with new HCPCS code C9732. Review the claim to ensure that you reported both codes. If you did, discuss this with your FI/MAC because there may be a problem in its claims processing system.

Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.



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