Ophthalmology and Optometry Coding Alert
CCI 16.0 Update:
Brace Yourself for Massive Injection Code Bundling in January
Also: CCI clarifies that eye exams are bundled into 'Welcome to Medicare' exams. You may ... Read more
Brace Yourself for Massive Injection Code Bundling in January
Also: CCI clarifies that eye exams are bundled into 'Welcome to Medicare' exams. You may ... Read more
Learn CCI Basics -- Or Watch Denials Flood In
Not overriding when you can means missing billable services. If you don't understand what... Read more
Not overriding when you can means missing billable services. If you don't understand what... Read more
Clear Up Diabetic Coding Confusion With These 3 Tips
Hint: Make sure your specific diabetic Dx matches the primary care physician's. If you're... Read more
Hint: Make sure your specific diabetic Dx matches the primary care physician's. If you're... Read more
Will Medicare's Consult Rule Trickle Down to Other Payers?
You'll follow 2 sets of rules unless insurers kiss 99241-99255 goodbye. When your ophthal... Read more
You'll follow 2 sets of rules unless insurers kiss 99241-99255 goodbye. When your ophthal... Read more
You Be the Expert:
Code Misdirected Eyelashes in the Right Direction
Question: What are the correct modifiers for 67820? Pennsylvania Subscriber Answer: ... Read more
Code Misdirected Eyelashes in the Right Direction
Question: What are the correct modifiers for 67820? Pennsylvania Subscriber Answer: ... Read more
READER QUESTIONS:
Unwrinkle Nursing Facility POS Codes
Question: Our ophthalmologists sometimes go to see patients in nursing homes. What crite... Read more
Unwrinkle Nursing Facility POS Codes
Question: Our ophthalmologists sometimes go to see patients in nursing homes. What crite... Read more
Reader Question:
Save 'Foggy Vision' for Secondary Dx
Question: Many of our patients claim general reasons for their visit, such as "I can't se... Read more
Save 'Foggy Vision' for Secondary Dx
Question: Many of our patients claim general reasons for their visit, such as "I can't se... Read more
Reader Question:
Weigh Pros and Cons of VF Codes
Question: We have a patient who is "glaucoma suspect." He is returning to our office for ... Read more
Weigh Pros and Cons of VF Codes
Question: We have a patient who is "glaucoma suspect." He is returning to our office for ... Read more
Ace Your A-Scan Reporting With Accurate LT, RT, and TC Modifier Use
Watch out for inconsistencies among your payers. A-scans are some of the most common proc... Read more
Watch out for inconsistencies among your payers. A-scans are some of the most common proc... Read more
Prove Medical Necessity for Pre-Bleph Visual Fields
Frustrated by denials for 'taped and untaped' VFs? To prove that blepharoplasty is medica... Read more
Frustrated by denials for 'taped and untaped' VFs? To prove that blepharoplasty is medica... Read more
News You Can Use:
CMS Will Offer Modifier to Denote Admitting Physician on Claims
Consultation changes make it crucial to report hospital visits properly. Practices across... Read more
CMS Will Offer Modifier to Denote Admitting Physician on Claims
Consultation changes make it crucial to report hospital visits properly. Practices across... Read more
Document 'Unrelated' for Modifier 79 Services
MACs looking for 'red flag' to halt additional global period pay. Billing for additional ... Read more
MACs looking for 'red flag' to halt additional global period pay. Billing for additional ... Read more
Reader Question:
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later ... Read more
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later ... Read more
Reader Question:
Note Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requir... Read more
Note Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requir... Read more
Reader Question:
Who Do You Bill When You're a Non-Par Provider?
Question: I have found it impossible to find out the allowable charge when your provider ... Read more
Who Do You Bill When You're a Non-Par Provider?
Question: I have found it impossible to find out the allowable charge when your provider ... Read more
You Be the Coder:
Dx for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our ophthalmologi... Read more
Dx for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our ophthalmologi... Read more
3 Scenarios Test Your Cataract Bundling Skills
Determine 'planned or unplanned' before separately coding vitrectomy. With several possib... Read more
Determine 'planned or unplanned' before separately coding vitrectomy. With several possib... Read more
2 Tips Lead to Proper Glaucoma Visit Coding
Let form and severity drive your coding choice. With 18 plus options to sift through when... Read more
Let form and severity drive your coding choice. With 18 plus options to sift through when... Read more
CMS Update:
2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new e-prescribing numerator code. CMS's 2010 Physician Fee Schedu... Read more
2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new e-prescribing numerator code. CMS's 2010 Physician Fee Schedu... Read more
Is Your Glaucoma Patient Truly at High Risk?
Medicare and most commercial insurances cover annual glaucoma screenings for high-risk ind... Read more
Medicare and most commercial insurances cover annual glaucoma screenings for high-risk ind... Read more
Reader Question:
Can an Assistant Perform Laser Scans?
Question: What level of supervision is required for an ophthalmic assistant conducting a ... Read more
Can an Assistant Perform Laser Scans?
Question: What level of supervision is required for an ophthalmic assistant conducting a ... Read more
Reader Question:
Report Toxicity Follow-Ups With E/Ms
Question: A primary care physician instructed one of our patients to see an eye doctor an... Read more
Report Toxicity Follow-Ups With E/Ms
Question: A primary care physician instructed one of our patients to see an eye doctor an... Read more
Reader Question:
Split Postoperative Cataract Care
Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient ove... Read more
Split Postoperative Cataract Care
Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient ove... Read more
Reader Question:
You Can Skip Modifier 51 for Some Carriers
Question: I previously often used modifier 51. Now, I'm unsure when it is required. Do so... Read more
You Can Skip Modifier 51 for Some Carriers
Question: I previously often used modifier 51. Now, I'm unsure when it is required. Do so... Read more
Reader Question:
Don't Modify Nonconclusive HRT Claim
Question: How should I code for a nonconclusive Heidelberg Retina Tomograph (HRT)? One of... Read more
Don't Modify Nonconclusive HRT Claim
Question: How should I code for a nonconclusive Heidelberg Retina Tomograph (HRT)? One of... Read more
Reader Question:
Require Patients to Shell Out for Special Frames
Question: I have a patient who wants to purchase a frame for $200. Medicare allows $74.06... Read more
Require Patients to Shell Out for Special Frames
Question: I have a patient who wants to purchase a frame for $200. Medicare allows $74.06... Read more
You Be the Coder:
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? Maine Subscriber Ans... Read more
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? Maine Subscriber Ans... Read more
News You Can Use:
Fee Schedule Cuts Medicare Pay By 21.2%, Scraps Consults
Bonus: CMS increases pay for office visit codes. Ophthalmology coders, get ready for anot... Read more
Fee Schedule Cuts Medicare Pay By 21.2%, Scraps Consults
Bonus: CMS increases pay for office visit codes. Ophthalmology coders, get ready for anot... Read more
Ensure That Eye Exams Are Coded at the Right Level by Following These Do's and Don'ts
Discovering common coding errors is the first step to correcting them. Overcoding and und... Read more
Discovering common coding errors is the first step to correcting them. Overcoding and und... Read more
Prepare for $89 Drop in Cataract Reimbursement Next Year
You'll also see $14 less for some established patient E/Ms. A quick glance at the propose... Read more
You'll also see $14 less for some established patient E/Ms. A quick glance at the propose... Read more
Reader Question:
Code Tumor Secondary to VF Defect
Question: How would you code a visual field defect arising from pituitary adenoma? Florid... Read more
Code Tumor Secondary to VF Defect
Question: How would you code a visual field defect arising from pituitary adenoma? Florid... Read more
Reader Question:
Avoid J2001 for Minor In-Office Procedures
Question: Is there a code we should bill for subcutaneous lidocaine or lidocaine with epi... Read more
Avoid J2001 for Minor In-Office Procedures
Question: Is there a code we should bill for subcutaneous lidocaine or lidocaine with epi... 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
Double OV Codes May Spell Double Trouble
Question: One of our ophthalmologists saw a patient in the morning for a LASIK evaluation... Read more
Reader Question:
Multiple FBs Might Mean Single Removal Code
Question: How should I report the encounter when the ophthalmologist removes a pair of no... Read more
Multiple FBs Might Mean Single Removal Code
Question: How should I report the encounter when the ophthalmologist removes a pair of no... Read more
Reader Question:
Count Prescriptions as Part of E/M
Question: Is there a code I can use for writing a prescription? If so, may I report it in... Read more
Count Prescriptions as Part of E/M
Question: Is there a code I can use for writing a prescription? If so, may I report it in... Read more
Reader Question:
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with CPT code 99024 and charge $0. Sometimes it goes thro... Read more
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with CPT code 99024 and charge $0. Sometimes it goes thro... Read more
You Be the Coder:
Should You Include Refraction Services in Exams?
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscriber An... Read more
Should You Include Refraction Services in Exams?
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscriber An... Read more
Case Study:
Overcome Silicone Hydrogel Lenses Coding Challenges Using These Basics
Know the appropriate codes for specific corneal conditions -- and give your practice... Read more
Overcome Silicone Hydrogel Lenses Coding Challenges Using These Basics
Know the appropriate codes for specific corneal conditions -- and give your practice... Read more
Don't Let 'Discontinued' Spell Disaster for Your Claims
Learn the best ways to know when modifier 53 applies -- or doesn't. Your physician w... Read more
Learn the best ways to know when modifier 53 applies -- or doesn't. Your physician w... Read more
Protect Your 99214s and 99232s With These CERT Musts
E/M codes need your attention to stay out of CMS trouble. In the wake of Medicare's Compr... Read more
E/M codes need your attention to stay out of CMS trouble. In the wake of Medicare's Compr... Read more
CCI 15.3 Update:
Include Moderate Sedation in Nearly All Eye Codes
Key: Role of second physician is critical in determining claims. Ophthalmology coders can... Read more
Include Moderate Sedation in Nearly All Eye Codes
Key: Role of second physician is critical in determining claims. Ophthalmology coders can... Read more
Reader Question:
2 Strabismus Surgeries: 67311 or 67312?
Question: An ophthalmologist removes a 6.5-mm section of the lateral rectus muscle of the... Read more
2 Strabismus Surgeries: 67311 or 67312?
Question: An ophthalmologist removes a 6.5-mm section of the lateral rectus muscle of the... Read more
Reader Question:
Beware of Repeat Laser Period
Question: A patient returns during the 90-day postoperative period of a focal laser for a... Read more
Beware of Repeat Laser Period
Question: A patient returns during the 90-day postoperative period of a focal laser for a... Read more
Reader Question:
Is Endothelial + Cataract IOL OK?
Question: An ophthalmic surgeon performs cataract surgery with IOL placement and then per... Read more
Is Endothelial + Cataract IOL OK?
Question: An ophthalmic surgeon performs cataract surgery with IOL placement and then per... Read more
Reader Question:
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? New Jersey Subscribe... Read more
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? New Jersey Subscribe... Read more
You Be the Coder:
What Codes for Orbit Exploration With Repair?
Question: What CPT code would be best to use for repairing a lacrimal gland prolapse? Bas... Read more
What Codes for Orbit Exploration With Repair?
Question: What CPT code would be best to use for repairing a lacrimal gland prolapse? Bas... Read more
3 Guidelines Untangle AMD Drug Supply Knot
With up to $2,191 at stake, knowing your payer's rules is critical. Sticking to yo... Read more
With up to $2,191 at stake, knowing your payer's rules is critical. Sticking to yo... Read more
Look to 362.52 for Wet AMD Dx
Use the same code for both 'classic' and 'occult.' AMD is the leading cause of blindness ... Read more
Use the same code for both 'classic' and 'occult.' AMD is the leading cause of blindness ... Read more
Think E/M Service When You Say 'Yes' to 5 Items
These questions let you ditch eye codes with confidence. Frustrated counting E/M codes' H... Read more
These questions let you ditch eye codes with confidence. Frustrated counting E/M codes' H... Read more
Clarification:
Medicare Secondary Billing Is Not Always Mandatory
Turns out if Medicare is secondary, you might not have to file the claim. An article in Op... Read more
Medicare Secondary Billing Is Not Always Mandatory
Turns out if Medicare is secondary, you might not have to file the claim. An article in Op... Read more
Are You Giving Credit for All Present Illness Info?
These clues will point you toward your ophthalmologist's HPI. If you stumble over the ele... Read more
These clues will point you toward your ophthalmologist's HPI. If you stumble over the ele... Read more
Reader Question:
Use Different Dxs to Support 2 EOs
Question: Could you shed some light on billing 92225 or 92226 with modifier 50, RT/LT, or... Read more
Use Different Dxs to Support 2 EOs
Question: Could you shed some light on billing 92225 or 92226 with modifier 50, RT/LT, or... Read more
Reader Question:
Eyes Break Bleph, Ptosis Bundle
Question: I started receiving denials for 15823 and 67904. To report this combo, should I... Read more
Eyes Break Bleph, Ptosis Bundle
Question: I started receiving denials for 15823 and 67904. To report this combo, should I... Read more
Reader Question:
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
You Be the Coder:
GDX, VF, & Temp Plugs: How Many Modifiers?
Question: A patient came in for a GDX and visual field (VF) tests. During the same visit,... Read more
GDX, VF, & Temp Plugs: How Many Modifiers?
Question: A patient came in for a GDX and visual field (VF) tests. During the same visit,... Read more
CCI 15.2 Update:
CCI 15.2 Update:Separately Reporting Exams Under Anesthesia? Read This First
Resistance is futile: Additional therapeutic injections are also now bundled with nearly ... Read more
CCI 15.2 Update:Separately Reporting Exams Under Anesthesia? Read This First
Resistance is futile: Additional therapeutic injections are also now bundled with nearly ... Read more
Focus on V2787 and V2788 for Toric and P-C IOLs
Let the patient know he's responsible for extra intraocular lens cost. Cataract surgeries... Read more
Let the patient know he's responsible for extra intraocular lens cost. Cataract surgeries... Read more
News You Can Use:
CMS Proposes Scrapping Consult Code Payment
Plus: 21.5 percent cut looms for your services. Heavy pay cuts for your ophthalmologist's... Read more
CMS Proposes Scrapping Consult Code Payment
Plus: 21.5 percent cut looms for your services. Heavy pay cuts for your ophthalmologist's... Read more
Answer:
Report any laser trabeculoplasty procedure
Question: If one of our ophthalmologists sees a patient with a chalazion, and at the time... Read more
Report any laser trabeculoplasty procedure
Question: If one of our ophthalmologists sees a patient with a chalazion, and at the time... Read more
Clarification:
Modifier 50 Won't Work on All Bilateral Claims
An article in Ophthalmology Coding Alert Vol. 12, No. 3, "Prevent Uni-Bi Reporting Errors ... Read more
Modifier 50 Won't Work on All Bilateral Claims
An article in Ophthalmology Coding Alert Vol. 12, No. 3, "Prevent Uni-Bi Reporting Errors ... Read more
Reader Question:
Report EOM Function Test With E/M
Question: The ophthalmologist wants to code for a "detailed evaluation of EOM function." ... Read more
Report EOM Function Test With E/M
Question: The ophthalmologist wants to code for a "detailed evaluation of EOM function." ... Read more
Reader Question:
Let Disease Damage, Control Drive VF Coding
Question: How often will Medicare allow visual field testing (92081-92083) on a patient? ... Read more
Let Disease Damage, Control Drive VF Coding
Question: How often will Medicare allow visual field testing (92081-92083) on a patient? ... Read more
Reader Question:
Does Old BB Gun Injury Have Bearing on Coding?
Question: We have a patient who came in for a routine eye exam, but reported retinal dama... Read more
Does Old BB Gun Injury Have Bearing on Coding?
Question: We have a patient who came in for a routine eye exam, but reported retinal dama... Read more
Reader Question:
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fundus photogra... Read more
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fundus photogra... Read more
Reader Question:
If Medicare Is Secondary, Don't Bill Patient
Question: Getting Medicare to pay when it is the secondary payer is difficult. Can we jus... Read more
If Medicare Is Secondary, Don't Bill Patient
Question: Getting Medicare to pay when it is the secondary payer is difficult. Can we jus... Read more
You Be the Coder:
SLT for Glaucoma
Question: What is the CPT code for SLT used for glaucoma? What about ALT? Wisconsin S... Read more
SLT for Glaucoma
Question: What is the CPT code for SLT used for glaucoma? What about ALT? Wisconsin S... Read more
Don't Let AMD Reimbursement Fade Away
Focus on 3 key areas to keep your claims on track. Nearly 2 million... Read more
Focus on 3 key areas to keep your claims on track. Nearly 2 million... Read more
Use These Modifiers for Accurate AMD Claims
As with other ophthalmology services, the wrong modifier can wreck an AMD claim. Fin... Read more
As with other ophthalmology services, the wrong modifier can wreck an AMD claim. Fin... Read more
Distinguish Between AMD Treatments:
Here's How
Get the lowdown on pros and cons for some of the more accepted options. ... Read more
Here's How
Get the lowdown on pros and cons for some of the more accepted options. ... Read more
NewsYou Can Use:
CMS Expects Practices to Use New HIPAA 5010 Form by 2012
Hint:Your ophthalmology practice wont be able to submit ICD-10 codes without t... Read more
CMS Expects Practices to Use New HIPAA 5010 Form by 2012
Hint:Your ophthalmology practice wont be able to submit ICD-10 codes without t... Read more
Correction:
Correction:
An article in Vol. 12, No. 3 of the Ophthalmology Coding Alert, Prevent Uni-Bi Repor... Read more
Correction:
An article in Vol. 12, No. 3 of the Ophthalmology Coding Alert, Prevent Uni-Bi Repor... Read more
Dry vs.Wet:
KnowYour AMD Terms
Age-related macular degeneration (AMD) is the deterioration of the macula, the centr... Read more
KnowYour AMD Terms
Age-related macular degeneration (AMD) is the deterioration of the macula, the centr... Read more
READER QUESTIONS :
Stick With E/M for Suture Removal
Question: Is there a code for when the ophthalmologist removes stitches from a... Read more
Stick With E/M for Suture Removal
Question: Is there a code for when the ophthalmologist removes stitches from a... Read more
READER QUESTIONS :
Modifier 50: MedicareWants Single-Line Entry
Question: I need some information on billing bilateral procedures. For Medicar... Read more
Modifier 50: MedicareWants Single-Line Entry
Question: I need some information on billing bilateral procedures. For Medicar... Read more
READER QUESTIONS :
UsingWrong Lesion Size Can Shrink Payment
Question: When determining the size of an excised lesion, should I go by the o... Read more
UsingWrong Lesion Size Can Shrink Payment
Question: When determining the size of an excised lesion, should I go by the o... Read more
READER QUESTIONS :
67311 Doesn't Require Surgery on Same Muscle
Question: One of our doctors operated on a vertical muscle of the right eye. L... Read more
67311 Doesn't Require Surgery on Same Muscle
Question: One of our doctors operated on a vertical muscle of the right eye. L... Read more
READER QUESTIONS :
Specify Tech vs. PhysicianWith Lens Codes
Question: My ophthalmologist sees routine patients for services such as contac... Read more
Specify Tech vs. PhysicianWith Lens Codes
Question: My ophthalmologist sees routine patients for services such as contac... Read more
You Be the Coder :
Office VisitWith Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision trainin... Read more
Office VisitWith Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision trainin... Read more
CCI 15.1 Update:
Watch Out for New Vitrectomy, Blepharoplasty Bundles
There are over 300,000 new edit pairs -- how many will impact ophthalmology coding? If... Read more
Watch Out for New Vitrectomy, Blepharoplasty Bundles
There are over 300,000 new edit pairs -- how many will impact ophthalmology coding? If... Read more
Do Your Devices, Injections, Scans Fit Under NewT Code?
Your vitrectomy claims could get a boost from this placement code. ... Read more
Your vitrectomy claims could get a boost from this placement code. ... Read more
Overcome Consultation Coding ConundrumsWith This FAQ
Caution: Avoid adding a consultation to every surgical procedure. W... Read more
Caution: Avoid adding a consultation to every surgical procedure. W... Read more
Correction:
Correction:
A Reader Question in Ophthalmology Coding Alert Vol. 12, No. 3 (“Eye Exam vs. Cons... Read more
Correction:
A Reader Question in Ophthalmology Coding Alert Vol. 12, No. 3 (“Eye Exam vs. Cons... Read more
READER QUESTIONS:
Billing Refractions Without Prescriptions
Question: Is it appropriate to bill a patient for 92015 even if the ophthalmol... Read more
Billing Refractions Without Prescriptions
Question: Is it appropriate to bill a patient for 92015 even if the ophthalmol... Read more
READER QUESTIONS:
Differentiate 375.15 and 370.21 by Condition
Question: Can 375.15 and 370.21 be used interchangeably? When would one be the... Read more
Differentiate 375.15 and 370.21 by Condition
Question: Can 375.15 and 370.21 be used interchangeably? When would one be the... Read more
READER QUESTIONS:
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fund... Read more
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fund... Read more
You Be the Coder:
E/M With 68761? Check Documentation First
Question: When I do a comprehensive exam (92004) and decide to insert punctal ... Read more
E/M With 68761? Check Documentation First
Question: When I do a comprehensive exam (92004) and decide to insert punctal ... Read more
CCI 15.0 Update:
Include Injections, Corneal Topography in Endothelial Keratoplasty Codes
Also: Despite new codes, eye exams are still bundled into critical care. If your ophthalmi... Read more
Include Injections, Corneal Topography in Endothelial Keratoplasty Codes
Also: Despite new codes, eye exams are still bundled into critical care. If your ophthalmi... Read more
Prevent Uni-Bi Reporting Errors With This Expert Insight
Know when to use RT/LT and when to rely on modifier 50. Don't let tricky prefixes stand in... Read more
Know when to use RT/LT and when to rely on modifier 50. Don't let tricky prefixes stand in... Read more
PQRI:
Make Sure These Errors Don't Cause Your PQRI Bonus to Tank
CMS shows which issues sidelined these practices. Most practices would agree that a 57.2 p... Read more
Make Sure These Errors Don't Cause Your PQRI Bonus to Tank
CMS shows which issues sidelined these practices. Most practices would agree that a 57.2 p... Read more
Clarification:
65222 May Be Better for Rust Ring Removals
The "You Be the Coder" challenge in Ophthalmology Coding Alert Volume 12, Number 1, reco... Read more
65222 May Be Better for Rust Ring Removals
The "You Be the Coder" challenge in Ophthalmology Coding Alert Volume 12, Number 1, reco... Read more
News You Can Use:
Say Goodbye to the 2+ Year Credentialing Period
CMS institutes 30-day billing window, effective Jan. 1. You're about to lose 26 months of ... Read more
Say Goodbye to the 2+ Year Credentialing Period
CMS institutes 30-day billing window, effective Jan. 1. You're about to lose 26 months 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
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:
Diagnosis Coding for Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim. The ophtha... Read more
Diagnosis Coding for Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim. The ophtha... Read more
Reader Questions:
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
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
Reader Questions:
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule for reimbursem... Read more
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule for reimbursem... Read more
Reader Question:
Settle the 'Paper or Electronic Claims' Debate
Question: Does Medicare accept paper claims anymore? I've heard that all claims have to be... Read more
Settle the 'Paper or Electronic Claims' Debate
Question: Does Medicare accept paper claims anymore? I've heard that all claims have to be... Read more
You Be the Coder:
2 Transposition Procedures = +67320 x 2?
Question: If the physician performs transposition procedures on the right medial and right... Read more
2 Transposition Procedures = +67320 x 2?
Question: If the physician performs transposition procedures on the right medial and right... Read more
Myth Buster:
Tighten Up Blepharoplasty Coding to Prevent Sagging Reimbursement
What you don't know can hurt you -- to the tune of $294 per procedure.Don't assume all eye... Read more
Tighten Up Blepharoplasty Coding to Prevent Sagging Reimbursement
What you don't know can hurt you -- to the tune of $294 per procedure.Don't assume all eye... Read more
PQRI Update:
Share in Bonus Payment With 3 New Ophthalmic Measures
When ophthalmologist doesn't meet measure, P modifier ensures compliance.Ophthalmology pra... Read more
Share in Bonus Payment With 3 New Ophthalmic Measures
When ophthalmologist doesn't meet measure, P modifier ensures compliance.Ophthalmology pra... Read more
Quick Key:
Show Medical Necessity for Blepharoplasty: Here's How
Diagnosis of a medical problem helps prove that eyelid procedure wasn't cosmetic.Each carr... Read more
Show Medical Necessity for Blepharoplasty: Here's How
Diagnosis of a medical problem helps prove that eyelid procedure wasn't cosmetic.Each carr... Read more
Reader Questions:
Reinforce Your 66180 and 67255 Coding
Question: Would it be appropriate to bill for both 66180 and 67255 at the same OR session ... Read more
Reinforce Your 66180 and 67255 Coding
Question: Would it be appropriate to bill for both 66180 and 67255 at the same OR session ... Read more
Reader Questions:
Hope for OCT Coverage for Plaquenil Exam
Question: What diagnosis code should we use for OCT when the patient is currently on Plaqu... Read more
Hope for OCT Coverage for Plaquenil Exam
Question: What diagnosis code should we use for OCT when the patient is currently on Plaqu... Read more
Reader Questions:
Look to Signs and Symptoms for Normal VF
Question: We had a patient present with high intraocular pressure, a symptom of glaucoma, ... Read more
Look to Signs and Symptoms for Normal VF
Question: We had a patient present with high intraocular pressure, a symptom of glaucoma, ... Read more
Reader Questions:
Notifying the Payer Isn't Likely to Help Collections
Question: When we send a patient to collections because she hasn't paid her deductible or ... Read more
Notifying the Payer Isn't Likely to Help Collections
Question: When we send a patient to collections because she hasn't paid her deductible or ... Read more
You Be the Coder:
Unilateral Botox Injection
Question: How would I report a Botox injection to control blepharospasm in only one eye?Ca... Read more
Unilateral Botox Injection
Question: How would I report a Botox injection to control blepharospasm in only one eye?Ca... Read more
2009 RVU Update:
Prepare to See $24 Less for ICG Angiography, $10 Less for A- and B-Scans
It's not all bad news: Your reimbursement for eye exams and E/M services should rise ... Read more
Prepare to See $24 Less for ICG Angiography, $10 Less for A- and B-Scans
It's not all bad news: Your reimbursement for eye exams and E/M services should rise ... Read more
Calculate Fees Differently in 2009
Here's how the BNA adjustment and the new conversion factor will change your reimbursement... Read more
Here's how the BNA adjustment and the new conversion factor will change your reimbursement... Read more
News You Can Use:
Begin Prepping for More Specific ICD-10 Today
New diagnosis-code book will change cataract dx codes -- and everything else. If you t... Read more
Begin Prepping for More Specific ICD-10 Today
New diagnosis-code book will change cataract dx codes -- and everything else. If you t... Read more
CPT 2009 Update:
New Endothelial Keratoplasty Code Valued at Almost $1000
You should see payment similar to other corneal transplant codes.Practices performing a re... Read more
New Endothelial Keratoplasty Code Valued at Almost $1000
You should see payment similar to other corneal transplant codes.Practices performing a re... Read more
Reader Questions:
Avoid Bilateral Modifiers on 76519, 92136
Question: The ophthalmologist calculated IOL power bilaterally in a patient's eyes. Should... Read more
Avoid Bilateral Modifiers on 76519, 92136
Question: The ophthalmologist calculated IOL power bilaterally in a patient's eyes. Should... Read more
Reader Questions; Report Cosmetic Ptosis Repair Separately
Question: We have a Medicare patient who will be having a levator resection on his right e... Read more
Question: We have a Medicare patient who will be having a levator resection on his right e... Read more
Reader Questions:
Describe Graft Revision With 66250
Question: After a pterygium removal, the patient's conjunctival allograft dislocated. The ... Read more
Describe Graft Revision With 66250
Question: After a pterygium removal, the patient's conjunctival allograft dislocated. The ... Read more
Reader Questions:
Document Complaint for Follow-Up Glaucoma Visit
Question: How should I code an office visit for a wheelchair-bound nursing home patient wh... Read more
Document Complaint for Follow-Up Glaucoma Visit
Question: How should I code an office visit for a wheelchair-bound nursing home patient wh... Read more
Reader Questions:
Modifier 78 Won't Provide Total Reimbursement
Question: I've noticed that when we report procedures with modifier 78, the payer will red... Read more
Modifier 78 Won't Provide Total Reimbursement
Question: I've noticed that when we report procedures with modifier 78, the payer will red... Read more
You Be the Coder:
Rust Ring Removal
Question: Our ophthalmologist removed a rust ring from a patient's central cornea, using a... Read more
Rust Ring Removal
Question: Our ophthalmologist removed a rust ring from a patient's central cornea, using a... Read more