Billing and Coding: Cataract Surgery

This billing and coding guidance requires documentation of medical necessity and comprehensive perioperative ophthalmologic evaluation for cataract surgery; only one cataract extraction CPT code (66830-66984) may be reported per eye. Complex procedures (CPT 66982) require explicit operative justification, B-scan ultrasound is only covered when dense cataract precludes posterior visualization, and Medicare covers a conventional IOL plus one pair of glasses or contact lenses post-operatively; appropriate diagnosis codes, referring NPI (when required), and ABN/modifiers must be included on claims.

"Cataract causing impaired vision with documented symptomatic impairment of visual function that prevents satisfactory performance of activities of daily living (e."

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