Ophthalmic Coding Specialist Practice Test

In the context of coding for ophthalmological procedures, which of the following codes requires modifier -50 for bilateral submissions?

1. CPT code 66761

2. CPT code 65091

3. CPT code 66762

4. CPT code 65105

The correct answer is: CPT code 66761

Modifier -50 is used to indicate a bilateral procedure, which means the service is performed on both sides of the body during the same session. In ophthalmology, certain codes require this modifier when the same surgical procedure is performed on both eyes. CPT code 66761 pertains to the surgical treatment of a condition known as cataract with intraocular lens insertion, specifically for one eye. If the procedure needs to be performed bilaterally, coding guidelines stipulate that modifier -50 must be appended to indicate that both eyes have undergone the same procedure. The other codes in the list represent different procedures that do not require the bilateral modifier in the same manner. Some may be for unilateral procedures or specific situations where a bilateral submission does not apply. Thus, understanding the specific use of modifier -50 with relevant CPT codes is crucial for accurate coding and billing in ophthalmic practices. In summary, CPT code 66761 requires modifier -50 for bilateral submissions because it represents a procedure commonly done on both eyes, thereby necessitating clarity in the billing process to capture the full scope of the services rendered.