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Ophthalmology and Optometry Coding Alert

Clear Up Your Gonioscopy Coding With 3 FAQ Answers
Key: Get to know payer-specific rules before adding 92020 to another claim With only one ... Read more
Fast Facts on 92020
When performing a gonioscopy, an ophthalmologist examines the angle of the eye's anterior ... Read more
CPT 2008 Breaking News:
Get Specific in the New Year With 3 New Vitrectomy Codes
Also, look forward to tossing out the unclassified code for Lucentis If your ophthalmolog... Read more
CPT 2008 Breaking News:
Anticipate Easier Telephone Service Reporting This January
Bonus: A new code for e-visits may also be on the horizon If your ophthalmologist is on t... Read more
Don't Hold Your Breath on Consult Clarification
Ensure you know the 5 consultation keys -- we'll tell you what they are Rumors have circu... Read more
Reader Question:
Use Caution With FB Removal and E/M
Question: A patient with eye pain presented to our office. This is a Medicare patient our... Read more
Reader Question:
Double OV Codes May Spell Double Trouble
Question: One of our ophthalmologists saw a patient in the morning for a LASIK evaluation... Read more
You Be the Coder:
E/M Plus Multiple Tests Equals Coding Questions
Question: A patient came to our office for severe right eye pain, sensitivity to light, a... Read more
Stop Risking Over $60 Each Time You Report Eyelid Lesion Removal
Knowing the removal method is the key to picking the right code When your ophthalmologist... Read more
3 Rules Help You Tackle Vision vs. Medical Dilemmas With Ease
There are times when you should report S0620/S0621 -- we'll tell you when A patient prese... Read more
Turn to This Chart for Quick Lesion Excision Code Help
Keep this tool handy when checking your physician's documentation Coding eyelid lesion ex... Read more
Correctly -- and Effectively -- Append 54/55 With These Tips
Coordinate coding with the other physician or prepare for a slew of denials When an ophtha... Read more
Reader Questions:
Separate Diagnoses Will Not Guarantee Modifier 59
Question: One of the coders in our department insists that we can use modifier 59 if the s... Read more
Reader Questions:
Don't Miss V58.69 on Plaquenil Checks
Question: A patient taking Plaquenil for her arthritis needs to have her eyes monitored to... Read more
Reader Questions:
Report 64612 per Eye
Question: My ophthalmologists are starting to use Botox to treat blepharospasm. What code... Read more
Reader Questions:
Opt for E/M Code for Suture Removal Only
Question: Can we code for suture removal when our ophthalmologist isn’t the physic... Read more
Reader Questions:
Face-to-Face Is a Must for Medicare
Question: What is the best way to code for a family consult when the patient is not presen... Read more
You Be the Coder:
Aqueous Shunt Insertion With Graft
Question: My ophthalmologist performed an aqueous shunt but added an additional step. Befo... Read more
3 Crucial Points Help Solidify Your OCT Coding
Bonus: Learn when you can, and should, report 92135 more than onceWhen your ophthalmologis... Read more
Fast Facts on 92135
OCT stands for -optical coherence tomography,- and it's also sometimes called a retinal th... Read more
Breaking News:
Prepare for Steep Cuts in Medicare Payments in January
Caution: Expect reduction in E/M code reimbursementIf the proposed 2008 physician fee sche... Read more
Home In on the Details of CMS' 2008 Proposal
Tip: PQRI continues for next year, so get busy planning nowTake note of several changes CM... Read more
Quick Quiz:
Wondering if Your NPP Skills Are Up to Snuff? Test Yourself
Take this quiz to see if you should be hitting the incident-to coding booksEach time a non... Read more
Quick Quiz Answers
Answer 1: You should report an established patient  visit, depending on the level of ... Read more
READER QUESTIONS:
Secure POD for Glasses After Cataract Surgery
Question: Our office often provides eyeglasses to patients after cataract surgery. We-ve b... Read more
READER QUESTIONS:
Continue With Unlisted for LASIK
Question: Our office performs LASIK surgery for some patients. I-ve looked and looked for ... Read more
READER QUESTIONS:
Face-to-Face Is a Must for Medicare
Question: What is the best way to code for a family consult when the patient is not presen... Read more
READER QUESTIONS:
Find New ABN Forms on the CMS Web Site
Question: I've read that there's a new ABN form floating around out there, but I can't fin... Read more
You Be the Coder:
Keratoconus Contact Lenses
Question: I-m confused about when I should use 92070 versus 92310. Which one should I use ... Read more
Dodge Blepharoplasty Denials by Proving Medical Necessity With 2 VF Tests
Tip: Make sure you know your carrier's preference on E1-E4 vs. LT-RT Your ophthalmo... Read more
Prove Blepharoplasty Wasn't Just Cosmetic With These 14 Diagnosis Codes
Tip: Look beyond ICD-9's eye section -- there are more options than you think Your in... Read more
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Conquer VF Documentation Challenges With This Handy Worksheet
Proper interpretation and documentation will help show medical necessity If your opht... Read more
Be Frugal With Modifiers, or You May Face an OIG Audit
Myth: Always use 59 to unbundle same-session, different-reason procedures If you al... Read more
CCI 13.2 Update:
Add These 7 Bundles to Your List of Coding No-No's
Indicators of -1- offer you an out for exceptions -- if you meet the requirements Goo... Read more
Reader Questions:
No NCD? Look at LCD for Lucentis
Question: My physicians have started using Lucentis to treat wet macular degeneration. W... Read more
Reader Questions:
Report SureSight With Regular CPT Code
Question: Should I use 0065T instead of 92015 for a SureSight vision screening? New Mex... Read more
Reader Questions:
Report SureSight With Regular CPT Code
Question: Should I use 0065T instead of 92015 for a SureSight vision screening? New Mex... Read more
Reader Questions:
Ensure EO Is Actually Extended
Question: I just got a denial on 92226. I think I might be using this code incorrectly. ... Read more
You Be the Coder:
What Constitutes a Level-4 Eye Code?
Question: We do not dilate our VSP patients- eyes but still bill 92004/92014 because VSP... Read more
3 Steps Ensure Proper Punctal Plug Payment Every Time
Tip: Stress the importance of medical necessity in the documentation to your physician Wh... Read more
Fast Facts on 68761
2007 National Medicare Physician Fee Schedule Allowable: $131.50 when performed in the off... Read more
Weed Through PQRI Confusion With These Expert Tips
Key: Educate your staff and perform a test run soon Your time to prepare for the Physicia... Read more
Determine PQRI Problem Spots Before the July Deadline
Tip: Use G8300 as your test code You should be modifying your office and billing systems,... Read more
ICD-9 Update:
Add New Floppy Iris Dx to Your Arsenal Starting in October
You won't be challenged by a slew of ophthalmology edits this year Good news: Ophthalmolo... Read more
Reader Question:
Rule Out Separate Schirmer's Test Pay
Question: Can I separately report Schirmer's tests and E/M services?Wisconsin Subscriber ... Read more
Reader Question:
Setting Determines Crawford Tube Removal Coding
Question: How can I report the removal of Crawford tubes? Most tubes stay in for longer th... Read more
Reader Question:
CMS and CPT 'Consult' Criteria Differ
Question: Past Ophthalmology Coding Alert articles contain definitions that differ from CP... Read more
Reader Question:
Take the Work Out of WC Claims
Question: Our ophthalmologist saw a patient who came in after a work injury affecting his ... Read more
Reader Question:
Don't Fall Into the Level-3 E/M Coding Rut
Question: I think my physicians frequently perform office visits that warrant coding at le... Read more
You Be the Coder:
Eye Exam vs. Consultation Coding
Question: We had a 55-year-old patient with type 1 diabetes come in presenting with a chie... Read more
Carrier Spotlight:
Stop Using 65730 to Report DSLEK/DSAEK -- at Least to 1 Carrier
Also: TrailBlazer clarifies the acceptable diagnosis code for IOL exchange due to complica... Read more
Discover if You Can Capitalize on 1-Year NPI Extension
CMS admits defeat, promises progress on NPI-sharing   Good news: You'll have an extra... Read more
Translating Acronyms Is Your Key to Deciphering Op Reports
Use these tips to make turning abbreviations into codes much easier   Do you know you... Read more
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Let This Tool Guide You When You Encounter Acronyms
 If your physician's notes puzzle you, check this chart to decipher them We polled o... Read more
READER QUESTIONS:
Differentiate Avastin Coding by Carrier
Question: An article regarding Avastin in the September 2006 Ophthalmology Coding Alert st... Read more
READER QUESTIONS:
Don't Expect to Get Paid on 99050
Question: In the July 2006 Ophthalmology Coding Alert, an article addresses using 99050 fo... Read more
READER QUESTIONS:
Look at POS for Trabeculectomy
Question: I am trying to bill a revision for a trabeculectomy. I coded the initial procedu... Read more
READER QUESTIONS:
Banish Thoughts of Replacing Provider Numbers
Question: Will the NPI numbers we-re required to start using in May simplify our paperwork... Read more
You Be the Coder:
Vitrectomy With Membrane Peel and Endolaser
Question: We have a new retina specialist in our office. He did a vitrectomy with membra... Read more
NCCI 13.1 Update:
Master the Latest Coding Edits With This Comprehensive Rundown
The plus side: You can break these bundles using a modifier Just when you've got all the n... Read more
Breaking News:
CMS Extends 1500 Deadline: Don't Miss These Key Details
Find out how a red arrow on the form can make or break your claims Don't discard your old ... Read more
Foregoing Bilateral Payment? Learn When to Call On 50, LT, RT
 Modifier 50 can bring your practice 150 percent of the fee schedule amount You coul... Read more
Don't Bill 2 Same-Day, Same-Patient Hospital Visits
There's no reason you would ever have to bill two "new patient" office visits by the same ... Read more
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Use This Chart to Keep Bilateral Billing Rules at Your Fingertips
Find answers for bilateral billing questions on common ophthalmologic procedures If yo... Read more
Reader Questions:
Carefully Choose Between Modifiers 52 and 53
Question: How should I decide between modifiers 52 and 53? Pennsylvania Subscriber Answer:... Read more
Reader Questions:
Zoom In on Supervision Requirements
Question: If an NP or PA were to perform a diagnostic test, as long as it was within his s... Read more
You Be the Coder:
Trabeculectomy Suture Removal
Question: I am trying to bill for the removal of sutures the ophthalmologist placed during... Read more
Make A- Scan Coding As Easy As 1-2-3 With These Expert Tips
Caution: Bilateral modifiers may not be appropriate When you see words such as "ultrasou... Read more
Kiss Your Payments Goodbye If You Ignore SNF Patient Status
Not knowing covered services for SNF patients will cost you time and money If you think ... Read more
Accomplish Your CEU Goals Using Coding Publications You Already Receive
Bonus: This summary can put you 1 CEU closer to reaching your renewal requirement If you... Read more
Quick Quiz:
Test Yourself On New, Updated Ophthalmology Codes and Edits
3 questions help you grasp CPT 2007's changes and the latest NCCI bundles Still trying ... Read more
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Tackle Payment Troubles With This Sample SNF Contract
Tip: Provide a copy to the SNF and keep one for your records Date: This letter serves ... Read more
Reader Question:
Keep an Eye on Chronic Conditions
Question: The 1997 audit guidelines state that I can reach an extended history by updatin... Read more
Reader Question:
Avoid Billing Hassles For Service To Minor
Question: An ophthalmologist in our facility saw a minor child who got a black eye in sch... Read more
Reader Question:
Stop Looking for Prescription Service Code
Question: My physician heard that there's a code we can bill and be paid on for the writi... Read more
You Be the Coder:
Surgically Induced Astigmatism
Question: We have a patient who has had surgically induced astigmatism following cataract... Read more
Safeguard Glaucoma Screening Claims With Expert Answers to Your Top-3 Coding Questions
Determining eligibility comes before you even start to think about G0117 and G0118 Choosin... Read more
PAYMENT NEWS ~ Start Billing Medicare Patients for Extra Toric IOL Costs
Your physician -- and patients -- can now choose which IOL is the best option Go... Read more
Fight Back Against Consult Denials by Proving 5 R's
Not documenting the request could land you in hot water You can probably recite the three ... Read more
READER QUESTION ~ Use E/M Code for Patient-Generated Second Opinion
Question: I know that CPT deleted the confirmatory consult codes for reporting second op... Read more
READER QUESTION ~ Tackle Workers' Comp Denials With Separate Notes
Question: We have a patient who comes in for one diagnosis for his workers' comp coverage.... Read more
READER QUESTION ~ Coding All 99213s Isn't Playing It Safe
Question: I heard that if I report mostly CPT 99213s and keep my evaluation and management... Read more
READER QUESTION ~ Check for Slit-Lamp Use on Corneal FBR Claims
Question: A patient with a foreign body in her left eye presents to our office for treatme... Read more
YOU BE THE CODER ~ Multiple Injections in 1 Visit
Question: When billing for endophthalmitis patients, my doctor reports 65800 for paracente... Read more
VERSION 13.0 UPDATE:
Latest NCCI Edits Limit How You Use New Code 67346
First round of 2007 edits also deletes 2 C code bundles You don't want to miss several new... Read more
REIMBURSEMENT NEWS:
Breath Easier -- Congress Freezes CF, Thwarts Payment Cuts
You should expect stable payments in 2008, tooGood news: Congress acted at the very last m... Read more
Pay Close Attention to Place of Service or Risk Denials
Don't confuse nursing facilities and skilled nursing facilities Every claim requires a pl... Read more
Stay on Top of the NCCI 13.0 Edits With This Chart
Tack this list to your wall to ensure you don't miss on any of the new bundles The Nationa... Read more
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Simplify Your Place-of-Service Coding With This Reference Table
Fingertip guide to 5 POS codes eliminates confusion Choosing the correct place-of-service ... Read more
READER QUESTION:
Don't Code All Discontinuations the Same
Question: My ophthalmologist began a phacofragmentation cataract surgery with intraocular ... Read more
READER QUESTION:
Turn to Medicare Web Site for LCD Search
Question: Where can I go to look up Medicare carriers' local coverage determinations? Also... Read more
READER QUESTION:
Capture Self-Pays With NEMBs
Question: I keep hearing the term NEMB, but I'm not sure what exactly it is. I know that i... Read more
READER QUESTION:
Differentiate Tech vs. Physician With Lens Codes
Question: My ophthalmologist sees routine patients for services such as contact lens fitti... Read more
YOU BE THE CODER:
Strabismus Surgery on Both Eyes
Question: My ophthalmologist removed a 6.5-mm section of the lateral rectus muscle of a pa... Read more
CPT 2007 UPDATE:
Make the Most of the Reimbursement Opportunity in 92025
Finally, CPT adds a code for corneal topography Ophthalmology coders are reacting with ca... Read more
NEWS YOU CAN USE:
Don't Fret Over Upcoming Medically Unlikely Edits
Experts say the edits may help, not hinder, your coding Here it comes: Yet another set of ... Read more
COLLECTION BASICS:
Get the Lowdown on No-Show Best Practices
Tip: Make sure your carriers don't frown on payment penalties Every office has them -... Read more
CLIP & SAVE:
Let Patients Know Your No-Show Policy Up-Front With These Tools
Use a series of letters to explain the consequences of missed appointments Make all of you... Read more
Open Your Eyes to Code Exams Properly
Determine the difference between intermediate and comprehensive You must know the four di... Read more
Dump the Status Quo for Contact Lens Reporting
Find out which service is often underpaid by carriers CPT has altered the contact lens sec... Read more
YOU BE THE CODER:
Chalazion Treatments
Question: How should I report treatments for chalazions? Pennsylvania Subscriber ... Read more
READER QUESTION:
Avoid Repeat Denials With Modifier 76
Question: How should I report a service that the physician performs more than once in a da... Read more
READER QUESTION:
Capture IOL Exchange With 1 Code
Question: What code should I use to report when the ophthalmologist replaces an IOL becaus... Read more
READER QUESTION:
Meet the 4 R's Before Coding Consults
Question: Several hospital physicians are referring patients to my physician for "consult.... Read more
READER QUESTION:
Consider a Financial-Hardship Policy
Question: Is it OK for our practice to not collect a co-pay or deductible from a patient w... Read more
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