Ophthalmic Coding Specialist Practice Test

Is it appropriate to bill for a subconjunctival injection of anesthetic prior to a Lucentis injection?

1. Yes, it's separate from Lucentis

2. No, it's included in the Lucentis code

3. Yes, if performed by a different surgeon

4. No, unless it's billed with 67010

The correct answer is: No, it's included in the Lucentis code

Billing for a subconjunctival injection of anesthetic prior to a Lucentis injection is classified as included in the Lucentis code. When it comes to coding for ophthalmic procedures, certain aspects of a treatment are considered part of the overall service. In this case, the administration of local anesthesia, such as a subconjunctival injection, is typically bundled into the procedure being billed, which in this instance is the injection of Lucentis. The reasoning behind this bundling is based on the concept that the anesthetic is a routine part of the preparation for the main procedure and does not warrant additional charging. This approach streamlines billing and prevents unnecessary duplication of charges for components that are inherently included in the main service provided. Understanding these billing practices aids in accurately representing the services rendered and ensures compliance with coding standards.