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CODING & BILLING
the only lenses for which Medicare lets ASCs charge patients the difference between what Medicare reimburses for use of a regular IOL
($150) and the actual lens cost. Medicare doesn't care what kind of IOL
is placed in cataract procedures. If you implant a premium lens instead
of a regular IOL, Medicare's reimbursement of $150 for the IOL is
included in the payment of the cataract extraction procedure CPT
codes (66984, 66982, etc.), as usual. Even though the physician used a
different type of IOL, Medicare won't reimburse your center more for
the use of a premium lens in the case. That is where billing the patient
for the difference comes in — and the related compliance issues.
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