Cataract Post Op Bilateral Claim Processing

Each insurance company has requirements for billing claims. The information below is an example of data input on the invoice. If your carrier has different requirements, please contact support for assistance. 

See Cataract Post Op Claim Processing for instructions on claims for a single eye.

Instructions

There are multiple areas of the system that need to be accessed and/or updated to complete the claim processing. The right and left eye must be on separate invoices.

Surgeon's NPI

1. The surgeon's NPI must be displayed in box 17b of the HCFA. Ensure the surgeon's NPI is updated within Admin.
2. Access Admin > Vendors/Partners > External Providers > open the provider > Provider IDs.
3. In the field for NPI ensure there is data, add data if needed.
4. Click 'Save & Close.'
5. Log out and log in to see the changes associated to the setting. 

CPT Codes

A CPT code must be available separately; once for the right eye and once for the left eye. Your practice can add the necessary CPT codes in a variety of options, such as:

• Code listed with 66984 and 66984-55. 
• Code listed with 6698, 66984-RT, and 66984-LT.
• Codes listed with 66984, 66884-55, 66984-RT, and 66984-LT.

Ensure the fees are assigned to each code and have them displayed within your Common Services list. This allows the provider the ability to assign 2 CPT codes in the coding screen of the encounter when seeing a patient for a bilateral post op visit and assign the necessary diagnosis. Once the provider codes the encounter, the codes can be assigned in the Billing screen of the encounter.

• Add CPT Codes/Services
• Add Modifier to a CPT Code

Invoice

1. Complete the instructions for Cataract Post Op Claim Processing for one eye.
2. After the invoice has been submitted for the first eye, a second invoice must be created for the next eye.
3. Access the encounter > Billing screen.
4. Click '+ Create Invoice.'
5. Select the payer.
6. In the Unassigned tab, click the + icon and select the payer to assign the charges to the newly created invoice.
7. Open the newly created invoice and complete the processing steps for Cataract Post Op Claim Processing as noted in step #1.