Advanced Search

Ophthalmology and Optometry Coding Alert

CPT 2006 Update:
Welcome New Codes for Singh Filtration, Anti-Angiogenic Therapy
Don't use an unlisted-procedure code for transciliary filtration--insurers now require thi... Read more
2006 RVU Update:
Prepare to Take a $40 Hit for Photocoagulation Next Year
Plus:  See how cataract removal fares against Medicare's 4.4 percent conversion facto... Read more
Quick Quiz:
Don't Settle for A-Minus A-Scan Coding
Sharpen your skills, unravel the bilateral rules and get fully reimbursedOne of ophthalmol... Read more
Keep Modifiers in Line for Screenings and Refractions
Decide between GA and GY based on whether Medicare covers the serviceIf you don't want to ... Read more
No ABN? Turn to GZ
This is no win-win situation, but this modifier helps you make the best of itIt happens to... Read more
READER QUESTIONS:
Stick to 67028 for Kenalog Injections in Office
Question: I code for a group of ophthalmologists in a university hospital. When an ophthal... Read more
READER QUESTIONS:
Look at Procedure, Not Tool, for Vitreous Strands
Question: Our ophthalmologist has performed a YAG laser for a diagnosis of "vitreous stran... Read more
READER QUESTIONS:
Don't Stretch Case for Complex Cataracts
Question: Our ophthalmologist wants me to submit a claim for 66982, along with stretching ... Read more
READER QUESTIONS:
Teach Yourself the Rules for 80 and 82
Question: The ophthalmologist I code for sometimes performs surgery at a teaching hospital... Read more
You Be the Coder:
Append This Modifier for Katrina Service
Question: I heard there were special rules for coding services for Hurricane Katrina evacu... Read more
2006 Update:
CPT Consolidates Consult Coding for New Year
'Second opinions' become just another E/M serviceYou may have fewer choices to make when r... Read more
Coding a Consult? Be Sure to Document These 3 Points
Remember the 3 R's: Request, render and reportBefore you report consult services 99241-992... Read more
NCCI 11.3 Update:
Include Duct Probe in Dacryocystorhinostomy
The latest bundles also clarify the rules for IOL exchangesYou probably won't tear up when... Read more
Optimize Your OPT Coding With These Documented Diagnoses
Is the patient's CNV classic or occult?  The answer could be worth $323Ophthalmologis... Read more
READER QUESTIONS:
Don't View Rust Rings as Foreign Bodies
Question: Our ophthalmologist removed a rust ring from a patient's central cornea, using a... Read more
READER QUESTIONS:
Append 58 to Excision After Incision
Question: The ophthalmologist incised a patient's conjunctival cyst (68020). One week late... Read more
READER QUESTIONS:
Combat E-Code Rejections With 2 Steps
Question: Is it important that I use the E codes? Insurers keep rejecting claims that cont... Read more
READER QUESTIONS:
Avoid Double-Dipping for Discontinued Surgery
Question: One of my ophthalmologists had started a ptosis surgery but had to stop due to e... Read more
READER QUESTIONS:
Make Up Difference for Progressive Lenses
Question: I'm a little confused about coding for optical supplies. One of our patients got... Read more
You Be the Coder:
Exploratory Globe Surgery
Question: Can I report 67340 for exploratory surgery to rule out an open globe injury? The... Read more
Focus on Cataract Codes for Airtight Presbyopia-Correcting IOL Coding
Medicare won't cover the full cost, but this expert advice will help you get the reimburse... Read more
Arm Yourself With NEMB for Extra Intraocular Cost
Leave the ABNs aside for P-C IOLs and other Medicare noncovered servicesYou may think gett... Read more
News You Can Use:
Reporting Adjustable Sutures Bilaterally? Not Anymore
CMS ends 150 percent adjustment for 6 strabismus add-on codesWhen your ophthalmologis... Read more
ICD-9 2006 Reminder:
Start Using New Nonproliferative DR Diagnosis Codes Soon
Distinguish among mild, moderate or severe retinopathy beginning Oct. 1Even though the cal... Read more
Patient Registration Secrets to Save You Thousands
Steven M. Verno, CMBSI Thank you very much.  I would like to welcome everybody t... Read more
READER QUESTIONS:
Code Detachment Repair and Peeling Separately
Question: Our ophthalmologist performed a retinal detachment repair with vitrectomy, along... Read more
READER QUESTIONS:
Wait for Path Report for Eye Lesion Dx
Question: I'm having trouble with a diagnosis code for a lesion removal. The ophthalmologi... Read more
READER QUESTIONS:
Report Humphrey 10-2 Test as 'Extended' VF
Question: We now use procedure code 92083 for a 30-2 visual field. We think we should also... Read more
READER QUESTIONS:
Apply Initial EO Code to New Condition
Question: I'm confused about the extended ophthalmoscopy codes. Is 92225 for a new patient... Read more
READER QUESTIONS:
Link First Plaquenil Exam to Underlying Condition
Question: What is the proper way to code a visit to monitor a patient on a high-risk medic... Read more
READER QUESTIONS:
Focus on Total Time Spent in Counseling
Question: Our ophthalmologist spent a total of 50 minutes with an established patient and ... Read more
You Be the Coder:
Don't Turn Blind Eye to Levator Repair
Question: We have a Medicare patient who will be having a levator resection on his right e... Read more
Determine Surgical Approach, Technique to Hit Blepharoptosis Repair Coding Bull's-Eye
Misinterpreting the operative report, or failing to prove medical necessity, could cost yo... Read more
Quick Key:
11 Ways to Show Medical Necessity for Ptosis Repair
Pick the right ICD-9 code to show your carrier that eyelid procedures aren't cosmetic Alth... Read more
2006 RVU Update:
Brace Yourself-Proposed Schedule Slashes Fees for Most Eye Procedures
        Prepare to lose up to $73 on some surgeries - thanks to a 4.3... Read more
Forget This Screening Code and Forget Payment From CMS
Hint: Report V80.1 first for G0117, followed by any identified disease V codes play a vita... Read more
News You Can Use:
Amend Your 3-Prong Test for Glaucoma Screening in 2006
CMS proposes making Hispanics 65 and older eligible for G0117 Next year you may have to as... Read more
Back to Basics:
Brush Up on Your ICD-9 Know-How With 3 Quick Tips
If you're confused about fifth digits or V codes, read this It's almost time to replace t... Read more
Reader Questions:
Justify 2 Injections With 59
Question: If the ophthalmologist performs two separate intravitreal injections on the same... Read more
Reader Questions:
Report YAG Only Once Each 90 Days
Question: The ophthalmologist performed a YAG laser procedure to clear up a patient's afte... Read more
Reader Questions:
Get Technical With VFs Ordered by Outside Doctor
Question: We performed a visual field ordered by a doctor outside our practice. The patien... Read more
You Be the Coder:
Choose Lensectomy Code by Method
Question: Our ophthalmologist performed a pars plana vitrectomy, removing lens fragments f... Read more
Look to Special Services, E/M Codes for Traumatic Eye Injury Care
Medicare may not like these codes - but emergency FB removals may be worth an extra $50Tre... Read more
Reporting ED Codes for Ophthalmologist's Work? Read This First
The rules say only one doctor gets to report 99281-99285 - but it isn't always the ED doct... Read more
ASC Update:
Wait No Longer for Gold Weight Insertion Codes
Medicare lifts the weight from coders' shoulders with a glittering list of ASC proceduresI... Read more
Myth Buster:
Get Friendly With V Codes to Justify Pay for Plaquenil Exams
Reluctance to use V codes may keep valuable info from patients' recordsA patient arrives i... Read more
READER QUESTIONS:
Use 66985 for IOL After Cataract Sugery
Question: I need a procedure code for a piggyback lens. The patient had cataract surgery b... Read more
READER QUESTIONS:
Map Out Topography Payment With 92499
Question: A private carrier keeps denying our claims for corneal topography. I report 9249... Read more
READER QUESTIONS:
Include Slit Lamp Exam in Horner'sTest
Question: Our ophthalmologist performed a Horner's Syndrome eye test, using 10 percent coc... Read more
READER QUESTIONS:
Describe Wound Revision With 66250
Question: After a pterygium removal, the patient's conjunctival allograft dislocated. The ... Read more
You Be the Coder:
Abandoned Photocoagulation
Question: After discussing the risks and benefits of both cryotherapy and photocoagulation... Read more
NCCI 11.2 Update:
Take Out the Slack in Lid Repair Coding With New Ectropion, Entropion Bundles
The new edits may also prevent you from separately reporting injection G codes ever again ... Read more
Modifier Primer:
Coding OR Returns? Find Out The Reason for the Procedure
 If an initial retinal repair necessitates a second procedure, look to 78 When you ha... Read more
Not Counting Techs' Work in Eye Exams? Read This
Their services can boost the E/M level -  if they're following the incident-to rules ... Read more
Correction:
Navigate the Fee Schedule to Find Bilateral Surgery Indicators
An article in the February 2005 Ophthalmology Coding Alert, "Coding IOL Masters and A-Scan... Read more
ABNs from A to Z:
How to Get Paid for All Services You Provide
Presented by Stacie L. Buck, RHA, LHRM The following supplement to Radiology Coding Alert ... Read more
Reader Questions:
Back Up Vitrectomy Necessity With Documentation
Question: Is it OK to code separately 67005 or 67010 with 66984?Tennessee Subscriber  ... Read more
Reader Questions:
Catch Staged Procedure for Post-Op Injections
Question: A patient who had a trabeculectomy is coming in for 5-FU injections. How should ... Read more
Reader Questions:
Overlook Time Limits With Consults
Question: If my ophthalmologist performs an office consultation on a patient, how much tim... Read more
Reader Questions:
Report Brow Ptosis Repair Bilaterally
Question: My doctor performed a brow ptosis repair, and he wants to report it bilaterally.... Read more
You Be the Coder:
Does 66982 Mean Pre-Op Planning?
Question: Our billing manager wants to code 66982 every time she sees anything in the oper... Read more
ICD-9 2006 Update:
Report Severity of Nonproliferative DR With New Diagnosis Codes
Distinguish between mild, moderate or severe retinopathy - and use a separate code for DME... Read more
News You Can Use:
Earn 150 Percent of RVUs for Most Eyelid Surgery
CMS announces changes to bilateral status for epilation and lesion excision Misinterpreti... Read more
Does Your Fundus Photography Filing Measure Up?
Hint: 92250 plus these diagnostic tests should add up to $75 per patient In 2003, Med... Read more
Check Bilateral Rules Before Coding FP With FA
Forgetting modifier -50 could cost your practice $66 for each angiographyYour ophthalmolog... Read more
ASC Update:
Finally, ASCs Can Report ECP
66711 joins the list of covered procedures for ambulatory surgery centers Until now, coder... Read more
Reader Questions:
Keep Modifier -AP in the History Pages
Question: A staff member used modifier -AP appended to CPT code 92012. I've searched every... Read more
Reader Questions:
Find Medical Problem in Patient's Good Eye
Question: A patient with one good eye and one prosthetic eye came in for a yearly check. S... Read more
Reader Questions:
Code Consult for Each Request for Opinion
Question: Six months ago, the ophthalmologist did a consult in the hospital and has not se... Read more
Reader Questions:
Include AMT in Pterygium Removal
Question: What would be the best code to use for pterygium removal with amniotic membrane ... Read more
Reader Questions:
Report EOM Function Test With E/M
Question: My ophthalmologist wants to code for a "detailed evaluation of EOM function." Th... Read more
Reader Questions:
Strike Down Payer Downcoding
Question: I have a payer that routinely downcodes our E/M services. What can I do about th... Read more
You Be the Coder:
Curtain Effect
Question: What diagnosis code would one use for "curtain effect"?Vermont SubscriberAnswer:... Read more
Seal Off Leaky Reimbursement for Diabetic Retinopathy Treatments
Key: The right ICD-9 codes and modifiers can bring your practice an extra $900 for multipl... Read more
Use 2 Diabetes Codes for Sweet ICD-9 Compliance
This diagnosis coding trick can help you avoid denialsYou've found the correct ICD-9 code ... Read more
Reporting Multiple Laser Sessions Only Once? Think Again
2 different kinds of treatments mean 2 separately billable procedures Coding focal la... Read more
Treat Detached Retina as Unrelated to Cataract Surgery
DRs and dislocated IOLs are dangerous - for coders and patients Last month, we explained h... Read more
Clarification:
Report Reconstruction, Not Excision, if Only 1 Code Allowed
Two articles in recent issues of Ophthalmology Coding Alert give conflicting advice on rep... Read more
Clarification:
Report Reconstruction, Not Excision, if Only 1 Code Allowed
Two articles in recent issues of Ophthalmology Coding Alert give conflicting advice on rep... Read more
Reader Questions:
Unwrinkle Nursing Facility POS Codes
Question: Our ophthalmologists sometimes go to see patients in nursing homes. What criteri... Read more
Reader Questions:
Don't Kid Around With Pediatric Consults
Question: We have a pediatric ophthalmologist who has started to see patients for second o... Read more
Reader Questions:
Sew Up Wound Leak Repair Coding
Question: My ophthalmologist returned to the OR this morning to repair a wound leak follow... Read more
Reader Questions:
Include Pterygium Removal in Reconstruction
Question: The ophthalmologist performed a pterygium excision with graft, using an amniotic... Read more
Reader Questions:
Don't Modify Nonconclusive HRT Claim
Question: How should I code for a nonconclusive HRT? One of our patients had one done, but... Read more
Reader Questions:
Downcode E/M to Documented Components
Question: When we determine an E/M code, the chart we use to select the level of history i... Read more
Reader Questions:
Report 2nd Doctor's Post-Op Care With -78
Question: If Ophthalmologist 2 in our group practice provides post-op care for a patient w... Read more
You Be the Coder:
Topography for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our ophthalmologis... Read more
Break YAG Capsulotomies From Cataract Globals and Earn an Extra $160
Curious coding may kill your cataract reimbursement - documentation and modifiers will lea... Read more
NCCI Update:
Brace Yourself for More PDT, FA Bundles
Reporting injections separately will get you nowhere with Medicare If you're thinking abou... Read more
Avoid a Modifier -25 Rut for Same-Day E/M Services
Modifier -57 is the better bet for more intensive services If your ophthalmologist pro... Read more
Quick Key:
Get the NCCI 11.1 Lowdown Here
Check these new ophthalmology bundles and keep your claims clean The National Correct Codi... Read more
Reader Questions:
Code Intravitreal, Not Intravenous, for PDT
Question: For triamcinolone injections followed by PDT, is it correct to code 67028 (inste... Read more
Reader Questions:
Code Follow-Up ED Patient as Established
Question: An ophthalmologist saw a patient in the emergency department (ED) whom our group... Read more
Reader Questions:
Count Out Conscious Sedation in 2005
Question: I've heard rumors that CPT 2005 bundles conscious sedation into endoscopic... Read more
Reader Questions:
Say Hello and Goodbye to Indicator '9'
Question: What does the "9" in the modifier column of the NCCI edits mean? I thought it me... Read more
Reader Questions:
Don't Overlook NPPs for Incident-To Services
Question: Should we consider time as a factor when coding for educational or counseling se... Read more
You Be the Coder:
Multiple Eyelid Lesion Removals
Question: The ophthalmologist removed six lesions from a patient's right upper eyelid in F... Read more
Unwrap Glaucoma Post-Op Package for Proper Reimbursement
Knowing what's not included in the global package can mean $1,173 in additional income Whe... Read more
News You Can Use:
See Both Sides of New Bilateral Status for Eyelid Repair
CMS decision allows you to append modifier -50 to 46 additional procedures If you've gotte... Read more
Getting Denied for E/M Service With Plug Insertion? Read This
If documentation is on your side, fight back with these 4 steps You've coded what you're s... Read more
Correction
In the February 2005 Ophthalmology Coding Alert, we gave an incorrect answer in the quiz t... Read more
Reader Questions:
List Payment Modifiers Before -LT and -RT
Question: When I append multiple modifiers to a CPT code, is there any rule about the orde... Read more
Reader Questions:
Avoid Big Macugen Attacks With Proper Coding
Question: Our ophthalmologist is going to start administering Macugen to treat wet age-rel... Read more
Reader Questions:
Use Patient Status to Help Determine E/M Level
Question: During an office visit, my doctor performed an expanded problem-focused history,... Read more
Reader Questions:
Look to 65855 for All Laser Trabeculoplasties
Question: What is the CPT code for SLT used for glaucoma? What about ALT?Wisconsin Subscri... Read more
Reader Questions:
Modify Eye Codes Just Like E/M Codes
Question: I just started working in an ophthalmologist's office and I have a question abou... Read more
Reader Questions:
Report Subsequent Care if Doctor Initiated Treatment
Question: We use codes 99251-99255 for initial hospital consults. But what should we use f... Read more
You Be the Coder:
Corneal Relaxation Incision
Question: My ophthalmologist performed a corneal relaxation incision at the time of catara... Read more
Coding IOL Masters and A-Scans Together? Read This First
Tricky technical and professional components could cost you $86 per patientWhen your ophth... Read more
Powerfully Document Necessity For IOL Power Calculations
Don't let faulty diagnosis coding shortchange your claimsMedicare covers IOL calculation p... Read more
E/M Brushup:
Don't Sell Yourself Short by Underestimating MDM
4 steps help you fight downcoding by assessing medical decision-makingIf you underestimate... Read more
Quick Quiz:
Get a Grip on New Ophthalmology Codes and Bundles
5 questions to put your knowledge of CPT 2005 and NCCI 11.0 to the testStill trying to dig... Read more
READER QUESTIONS:
Don't Code Fundus Photos Bilaterally for Medicare
Question: Is it appropriate to append modifier -50 to code 92250? Our new software program... Read more
READER QUESTIONS:
Fall Back on Unlisted-Procedure Code for Intacs
Question: I need a more specific CPT code for billing intacs. I have used 66999 in the pas... Read more
READER QUESTIONS:
Pay Attention to Global for Focal Laser
Question: A diabetic patient underwent focal laser treatment and panretinal photocoagulati... Read more
READER QUESTIONS:
Line Up Modifiers Without -99
Question: Medicare is denying payment for cataract surgery on the second eye. I learned a ... Read more
You Be the Coder:
Jones Tube Cleaning
Question: How should I code for the cleaning of a Jones tube? Our patients usually come in... Read more
NCCI 11.0 Update:
Not Reporting Cataract Extractions With Pars Plana Vitrectomies? Now You Can
The first coding bundles of 2005 also tell you what you can - and can't - bill with the ne... Read more
Edits at a Glance:
Get the NCCI 11.0 Skinny Here
  Forget wrestling with CMS spreadsheets - here's how the new bundles will affect yo... Read more
Check the Fee Schedule Before Billing Bilaterally
Just because the patient has two eyes doesn't mean modifier -50 applies If you've been ha... Read more
CPT Reminder:
No More Amazing Grace Period To Use New Codes
Starting Jan. 1, you'll have to start reporting the new codes immediately CMS has scrapped... Read more
Are You Ready to End Your E/M-Guideline Confusion? We Can Help
Use CMS' responses to our questions to report correct E/M levels Like many coders,... Read more
You Be the Expert:
Should You Factor Patient's Status?
Question: During an office visit, my doctor performed an expanded problem-focused history,... Read more
Bonus Question:
Improve Your Prescription Drug Documentation
Find out what CMS has to say about the management options category Calculating a patient's... Read more
Reader Questions:
Append -GV or -GW for Hospice Visits
Question: While I was away, my ophthalmologist saw a hospice patient. He left a note on th... Read more
Reader Questions:
Avoid Billing Services When Patient Isn't Present
Question: A patient comes in to discuss the care of his wife, who is also a patient and wh... Read more
Reader Questions:
Report Bleb Needling Separately Only in OR
Question: My ophthalmologist performed a needling procedure during the postoperative perio... Read more
Reader Questions:
Code YAG Laser as Often as Medically Necessary
Question: Can a YAG be billed more than once in a patient's lifetime?Iowa Subscriber Answe... Read more
Reader Question:
Let the Elements Drive Your History Documentation
Question: The chart that physicians use to select the level of history includes identifier... Read more
You Be the Coder:
Glaucoma Follow-Up for Nursing Home Patient
Question: How should I code an office visit for a wheelchair-bound nursing home patient wh... Read more
Available Years:  2005  2004  2003  2002  2001  2000  1999  1998