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Sure Fire Reimbursement Techniques On Your FBR Medical Billing Claims

Sure Fire Reimbursement Techniques On Your FBR Medical Billing Claims

When you’re reporting a medical billing claim for foreign body removal (FBR) from the eye on many occasions you may not be getting the full reimbursement that is due because you might be missing something extra.

A good example is if a patient presents to the ED with a foreign body in her left eye. The ED physician performs a removal of the foreign body and uses a slit lamp in the procedure. A level three evaluation was also performed to check for additional injury caused by the presence of the foreign body. In most cases, you’ll be able to report a pair of CPT codes. One for the ED visit as well as the FBR.

In most instances you should use the following technique:
* report 65222 (Removal of foreign body, external eye; corneal, with slit lamp) for the FBR.

* report 99283 (Emergency department visit for the E/M of a patient, which requires these three key components: an expanded problem-focused history; an expanded problem-focused examination; and medical decision-making of moderate complexity).

* attach modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to 99283 to show that the E/M was a significant and separate service from the FBR.

* link 930.0 (Foreign body on external eye; corneal foreign body) to 65222 and 99283 to prove medical necessity for the encounter.

If a slit lamp is not used, be sure to use 65220 (… corneal, without slit lamp) instead of 65222. Using the correct and logical coding sequence will ensure that your medical billing claims are fully reimbursed instead of denied or only partially paid!

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