Ophthalmic Coding Specialist Practice Test

When submitting a claim for bilateral laser iridotomy for Medicare Part B patients, the correct approach is to submit it as one line item modified by -50. This modifier indicates that the procedure was performed bilaterally, effectively communicating to Medicare that both eyes were treated during the same session.

Using modifier -50 is standard practice for bilateral procedures, as it allows for the procedure to be billed once while still ensuring that the insurer recognizes it as involving both sides of the body. This method enhances the accuracy of billing and reduces the potential for confusion regarding the services rendered.

In contrast, listing two separate line items could lead to complications in processing, as it may not clearly convey that they are part of the same procedure performed bilaterally. Similarly, submitting one line item without any modifiers would not adequately indicate that the treatments were bilateral, potentially resulting in incomplete reimbursement. Lastly, submitting a single line item with a quantity of two does not specify that it is one procedure done on both eyes, which might not be recognized in the same way as using the appropriate modifier.

By using modifier -50, the billing becomes precise and adheres to Medicare's guidelines for bilateral procedures, ensuring proper reimbursement and minimizing the risk of claim denial.