Ophthalmic Coding Specialist Practice Test

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If YAG capsulotomies are performed on both eyes the same day, what percentage of payment is provided?

  1. 200%

  2. 150%

  3. 100%

  4. 75%

The correct answer is: 150%

When YAG capsulotomies are performed on both eyes on the same day, the payment is typically set at 150% of the standard procedure fee for the first eye and 50% for the second eye. This payment structure reflects the understanding that while performing surgery on the second eye is less complex, it still requires resources and time. Therefore, when considering both eyes together, the total reimbursement amounts to 150% of the initial payment for a single YAG capsulotomy. This makes sense clinically and financially, as it compensates the provider adequately for performing two procedures while reflecting the reduced resource intensity for the second procedure.

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