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Ophthalmology and Optometry Coding Alert

New CPT Codes for OPT and IOL Master
CPT Codes 2002 creates two important new codes for ophthalmologists: a biometry c... Read more
Use Modifiers -50, -51 or -E for Multiple Eyelid Procedures
Successfully billing multiple procedures on eyelids depends on using the correct m... Read more
Follow Carrier Rules for Vision Rehabilitation
Vision rehabilitation, a growing field that presents many coding challenges for ophthalm... Read more
News Brief:
Medicare Will Cover Glaucoma Screening for High-Risk Patients
As of Jan.1, 2002, Medicare will cover an annual glaucoma screening for high-risk patients... Read more
Reader Question:
Ophthalmoscopy and Fundus Photography
Question: Can I bill 92225 and 92250 at the same visit for a patient with retinal pro... Read more
Reader Question:
IOP and Office Visit
Question: A patient has elevated intraocular pressure (IOP) due to steroids after cataract... Read more
Reader Question:
Adjustable Suture
Question: When billing a muscle surgery with adjustable suture add-on, should I use modifi... Read more
Reader Question:
Plaquenil Exam
Question: Which code (diagnosis and CPT) should I use for a baseline Plaquenil exam?Ohio S... Read more
You Be the Coder:
Xanthelasma Excision
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Modifiers -24 and -25 for Office Visits and Minor Procedures Increase Payment
When performing a minor procedure on the same day as an office ... Read more
Medicare Determines Status for Unilateral/Bilateral Procedures
" When billing for a procedure performed on both eyes, the coder must... Read more
Clarification:
Steroids and IOP
In the August issue we discussed visual field testing (92081-92083) on patients being trea... Read more
News Brief:
No Changes to ICD-9 Codes for 2002
There are no revisions or additions to ophthalmology diagnosis codes for 2002. The two new... Read more
Reader Question:
Home Services
Question: On his way home, our ophthalmologist visited an age-related macular degenerati... Read more
Reader Question:
Modifiers -22 and -52
Question: When can we use modifier -22 to get paid more for a complicated procedure? I... Read more
Reader Question:
IOP Post-Cataract Surgery
Question: Some of our cataract surgery patients develop increased pressure after the ope... Read more
You Be the Coder:
Gonioscopy With Eye Exam
Test your coding knowledge.  Determine how you would code this situation bef... Read more
Earn Proper Payment for Visits to Nursing Homes
Ophthalmologists and optometrists, in association with their respective eye-care groups,... Read more
CPT and Payers Determine Rules for Coding LASIK
" LASIK (laser-assisted in situ keratomileusis) is a high-paying refractive pr... Read more
News Brief:
HHS Suspends E/M Guideline Changes
Testifying before the House Ways and Means Committee on July 19, 2001, Tommy Thompson, sec... Read more
News Brief:
Visual Field Testing Codes
Ophthalmologists billing National Health Information Center (NHIC) for visual field testin... Read more
Reader Question:
Corneal Topography
Question: How should we bill for corneal topography? Colorado Subscriber  Answer: T... Read more
Reader Question:
Fundus Photography
Question: Im confused about billing for fundus photography. Should we bill for both eyes s... Read more
Reader Question:
Foreign Body
Question: A patient had a metallic foreign body removed from his eye by a different physic... Read more
Reader Question:
Intravitreal Gas
Question: How should we bill for the release of intra-vitreal gas done in the office? ... Read more
Reader Question:
Plaquenil Exams
Question: Which codes (diagnosis and CPT) should we use for baseline Plaquenil exams?&nb... Read more
You Be the Coder:
Botox Treatment
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Optimize Reimbursement for Treating Traumatic Eye Injuries
Coding for traumatic eye injuries depends on whether the ophthalmologist provides tr... Read more
Confusion Over EO:
Medicare Requirements Depend on Your Location
 Depending on the location, Medicare carriers have widely varying requirements ... Read more
Reader Question:
LASIK Surgery
Question: How can we be reimbursed for LASIK surgery?Montana Subscriber  Answer: Bec... Read more
Reader Question:
Low Vision
Question: How can we bill and be paid for low-vision evaluations and treatment?Delaware ... Read more
You Be the Coder:
Strabismus and Cataract Surgery
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Proper Use of Modifiers Increases Payment for Discontinued Procedures
When an ophthalmologist begins a surgical procedure but can't complete it, coders should... Read more
ASC Billing:
Get Complete Reimbursement for Incomplete Procedures
Incomplete procedures have different billing rules for ambulatory surgical centers (ASCs... Read more
Avoid Fraud:
Be Cautious When Using Medical-Necessity Lists
In Medicare, the computer that reads your claims determines quickly whether a procedur... Read more
News Brief:
CPT Issues New Technology Temporary Codes
CPT issued temporary codes for emerging technologies, including codes for transpupillary t... Read more
News Brief:
HCFA Changes Name to CMS
The Health Care Financing Administration (HCFA), which administers Medicare and Medicaid p... Read more
Reader Question:
Vitrectomy
Question: How can we get paid for a vitrectomy with membrane peeling, especially when it i... Read more
Reader Question:
Eye Exams
Question: I am bothered by the fact that some insurance companies -- namely, MA... Read more
You Be the Coder:
Pachymetry
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
New Cataract Surgery Code Is Payable in ASCs
Medicare has announced that it will cover 66982 (extracapsular cataract removal with ins... Read more
Bill Q3013 for Visudyne
Medicare has instructed carriers to accept HCPCS code Q3013 (this ... Read more
Turn Surgical Complications and Iatrogenic Incidents Into Ethical Reimbursement
When mistakes during surgery lead to extra work for the physician but do not harm th... Read more
Avoid Fraud:
Patient Complaint, Not Diagnosis, Should Drive Coding
Ophthalmologists choose diagnosis codes based on the patient's condition, but whether ... Read more
Reader Question:
Botox
Question: How should we code for the injection and supply of Botox? Also, how should we ... Read more
Reader Question:
Ophthalmoscopy
Question: How should I bill for extended ophthalmoscopy (92225-92226)? Is one cod... Read more
You Be the Coder:
CME
Test your coding knowledge. Determine how you would code this situation before looki... Read more
Follow CPT Rules for Ethical Use of New Cataract Surgery Code
Confusion persists regarding 66982, the new code for complicated cataract surgery. Some ... Read more
CCI Update:
Providers Wait for HCFA Education on A-Scans and Office Visits
When CCI 6.3 implemented the massive bundling edits last fall, ophthalmology coders wonde... Read more
BC/BS of Kansas Releases LMRP for 66982
At least one Medicare carrier has issued a local medical review policy (LMRP) for 66982, t... Read more
Diagnostic Supervision Rules Reinstated Effective July 1
HCFA published new supervision rules in 1997, but the rules were put on hold in 1998. On A... Read more
Reader Question:
IOL Master
Question: How do we bill for the intraocular lens (IOL) Master?Texas SubscriberAnswer: For... Read more
Reader Question:
Vitrectomy and Cataract Surgery
Question: How do we bill for cleaning up with a vitrectomy (67010) after cataract surgery ... Read more
Reader Question:
YAG on Both Eyes
Question: What is the proper way to bill and be paid for a Ytrium-Aluminim-Garnet (YAG) pe... Read more
You Be the Coder:
Diagnostic and Treatment Plan
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Use Modifier -26 to Optimize Pay for Fundus Photography
Proper billing of modifier 26 (professional component) and modifier -TC (technical compone... Read more
Dont Use Routine as the Reason for a Follow-up Visit
When an ophthalmologist documents a follow-up visit for a chronic condition, he or she sho... Read more
CCI 7.1 Bundles Punctal Dilation with Plug Placement
CCI version 7.1 includes three sets of bundles that affect ophthalmologists. One set of th... Read more
News Brief:
HCFA Reverses Decision on Billing for Refractions
When coding for refractions (92015), ophthalmology coders often get confused about the di... Read more
Use 92135 for the New Scanning Laser
When the scanning laser (CPT 92135, scanning computerized ophthalmic diagnostic imaging [e... Read more
Reader Question:
General Services
Question: What are the documentation requirements for the use of 92002-92014?California Su... Read more
Reader Question:
Intraocular Lens
Question: How should we bill for in-office repositioning of an intraocular lens (IOL) that... Read more
Reader Question:
Routine Eye Exams
Question: Do I need a waiver for routine eye exams?Wisconsin Subscriber Answer: Medicare v... Read more
Reader Question:
Two Surgeons
Question: If Dr. A performs cataract surgery, and the next day Dr. B performs a posterior ... Read more
You Be the Coder:
Cyst Removal
Question: How should we bill removal of a cyst on the upper lid? Pennsylvania SubscriberTe... Read more
Optimize Reimbursement by Coding Epilation Per Lid for Medicare, Per Eye for Other Payers
Ophthalmology coders often dont know whether to code epilation (the removal of an ingrow... Read more
Know Diagnosis and Treatment Coding Options for Macular Degeneration to Receive Proper Payment
Macular degeneration, thrust into the spotlight by recent advances in laser treatment, ha... Read more
News Brief:
Stark II Offers Good News for Ophthalmologists
Under a much-anticipated exemption to the Stark II referral ban, ophthalmologists will be ... Read more
Use 92012, Not 92014, to Get Paid for Most Followup Visits
When billing followup visits for patients with chronic conditions, 92012 (ophthalmologic... Read more
Ophthalmologists Will Be Reimbursed for Visudyne
As of July 1, 2001, ophthalmology coders should use HCPCS code Q3013 for Visudyne (per 15 ... Read more
Reader Question:
Consultations
Question: An optometrist in our practice refers patients to the ophthalmologist, also in t... Read more
Reader Question:
Panretinal Photocoagulation
Question: If a physician treats a patient with the PRP (panretinal photocoagulation) laser... Read more
Reader Question:
Photodynamic Therapy
Question: Is there a postoperative period for the new photodynamic therapy (PDT) codes, 96... Read more
Reader Question:
Cataract Removal
Question: When can we use the new cataract surgery code?Maine Subscriber Answer: Ophthalm... Read more
Reader Question:
Ultrasound Biometry
Question: When should the charge for ultrasound biometry with IOL calculations be submitt... Read more
Reader Question:
Retina Tomograph II
Question: We recently purchased the Retina Tomograph II. I know that the procedure code ... Read more
You Be the Coder:
LASIK
Question: What code should we use to bill LASIK?Florida SubscriberTest your coding knowled... Read more
Ethically Maximize Reimbursement with Codes for Regular Followup Visits
For optimal reimbursement, use the established patient, general ophthalmological services ... Read more
Avoid Fraud:
Do Not Overuse New Cataract Surgery Code
Ophthalmologists and their coders may be tempted to use the new cataract surgery code freq... Read more
HCFA Temporarily Suspends Part of CCI 6.3
HCFA has temporarily suspended many of the edits in version 6.3 of the national Correct Co... Read more
New Vision Screening Code Not for Ophthalmologists
Ophthalmologists may be wondering if they should use a new code in CPT 2001 for vision s... Read more
News Alert:
HCFA Rejects Modifier -60
Modifier -60 (altered surgical field), a new surgical modifier in CPT 2001, will not be ... Read more
Reader Question:
Preoperative Exams
Question: How can we bill for preoperative exams given by the ophthalmologist or technicia... Read more
Reader Question:
Pars Plana Vitrectomy
Question: A patient has proliferative diabetic retinopathy with traction retinal detachmen... Read more
Reader Question:
Discontinued Procedure
Question: A patient had cataract surgery, and in the middle of surgery something happene... Read more
You Be the Coder:
Intraocular Lens
Question: If we have an ambulatory surgical center (ASC), how can we get paid for intraoc... Read more
Get Paid for Treating Increased Intraocular Pressure During the Postoperative Period
When a patient presents with increased intraocular pressure (IOP) during the postoperative... Read more
Receive Appropriate Reimbursement for Technician Services
To avoid fraud and receive appropriate reimbursement, ophthalmology coders must know when... Read more
CCI Update:
CCI 7.0 Unbundles 67108 and 67038
Version 7.0 of the Correct Coding Initiative (CCI) has removed a bundle pursuant to a req... Read more
News Brief:
Glaucoma Screening Reimbursement on the Horizon
A new federal law will allow reimbursement for ophthalmologists for glaucoma screening. On... Read more
Reader Question:
Low Vision Consultation
Question: A patient was referred by an ophthalmologist in our practice to an optometrist i... Read more
Reader Question:
Global Surgical Package
Question: When a surgical package is co-managed, what does the ophthalmologist need to tel... Read more
Reader Question:
Intraocular Lens Insertion
Question: What is the proper way to code intraocular lens (IOL) insertion at the same time... Read more
You Be the Coder:
Transient Lid Spasm
Question: What is the diagnosis code for a transient lid spasm? The doctor wrote this in... Read more
Get Paid for Same-day A-scan and Office Visit by Appending Modifier -25
A-scans (76516-76519) are now bundled into evaluation and management (E/M) services code... Read more
Modifier -60:
Optimize Reimbursement for Complicated Surgeries
Its too soon to say how carriers will respond to modifier -60 (altered surgical field). ... Read more
Diagnosis Coding is Key to Payments for 65772 or 65775
Ophthalmologists who bill 65772 (corneal relaxing incision for correction of surgically in... Read more
News Brief:
New Codes Approved for Photodynamic Therap
When the Food and Drug Administration (FDA) approved Visudyne last spring, ophthalmologist... Read more
Reader Question:
Extended Visual Fields
Question: What level of supervision does 92083 (extended visual fields) require: level 1 (... Read more
Reader Question:
Billing for Emergencies
Question: Our ophthalmologist is sometimes called to the hospital emergency department to ... Read more
Reader Question:
Corneal Topography
Question: How should we bill for corneal topography? Our ophthalmologist says there must... Read more
You Be the Coder:
Eye Exam
Question: Can we use modifier -24 on an eye exam code (92002, 92004, 92012, 92014)? Montan... Read more
Available Years:  2001  2000  1999  1998