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Ophthalmology and Optometry Coding Alert
Ophthalmology and Optometry Coding Alert
Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 12
Diagnostic Tests :
Part I: Are You Coding Diagnostic Tests Correctly?
From refractions to EO, read on for a refresher of the general rules and guidelines for ...
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ICD-10 :
Watch H54 Family for Streamlined Visual Impairment Coding
Choose from 17 codes for blindness, low vision conditions in either eye. While the eno...
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Medicare Physician Fee Schedule :
Get These Updates to Global Surgical Package and Incident- To Billing
Fees and compliance issues lead providers’ concerns. First, the good news &mdash...
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Reader Question :
Avoid ICD-9 and ICD-10 on 1 CMS-1500 Form
Question: Our physician admitted a patient in September and didn’t discharge ...
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Reader Question :
Look to Z98.4 for Cataract History
Question: When coding for cataract surgery, is it required or optional to code Z98....
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Reader Question :
Pinpoint POS Codes with This Quick Guide
Question: I have heard that MACs are paying close attention to our place of service (POS...
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You Be the Coder :
Epilation and E/M During YAG Global
Question: One of our patients is still in the global period for a YAG laser procedu...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 11
Extended Ophthalmoscopy:
Know the EO Rules to Safeguard Deserved Payment
Don’t let coding errors rob your practice of $28 each time. With approximately $...
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Coding Quiz:
Are You Up on CPT® 2016?
Codes for corneal ring segments, among others, are coming – test your knowledge no...
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ICD-10:
Get to Know Your 30 New Options for Vitreous Disorders
The diagnosis code set expands nearly fourfold with H43 series. As coders nationwide h...
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ICD-10:
Practices Report Mostly Smooth Sailing Through ICD-10 Transition
Some potential issues, however, may remain to be seen. If you asked medical practices ...
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ICD-10:
Understand Grace Period
Check out these resources, too. You’re using ICD-10, and you’re not too su...
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Reader Question:
Append Modifier 25 for E/M With Plug Insertion
Question: When my optometrist does a comprehensive exam (92004) and decides to inse...
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Reader Question:
"No Charge" Visits Still Count Toward Established Patient Status
Question: Our ophthalmologist saw a patient during a quick assessment last year at ...
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Reader Question:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a dir...
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You Be the Coder:
Complex Cataracts With Iris Hooks,Staining
Question: Our ophthalmologist wants me to submit a claim for 66982, along with stre...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 10
CPT® 2016:
Get Ready for Corneal Ring Segment, Collagen Cross-Linking Codes
New and revised procedure codes reflect improving technology. Along with the changing ...
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ICD-10:
Seek Out H47 Series for Optic Disc Disorders
With the new diagnosis codes officially in play, say goodbye to the 377.xx ICD-9 codes. ...
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ICD-10:
Follow These Essential Tips to Embrace ICD-10 Implementation This Month
What is new ahead? See more combination codes and seventh digits; You needn’t fear...
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Compliance:
Ophthalmology Providers in WV, NJ Logged High Error Rates
Ophthalmology Providers in WV, NJ Logged High Error Rates OIG report shines spotlight ...
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Reader Question:
Obey the 60-day Max for Locum Tenens
Question: We will employ a substitute physician to fill in for one of our ophthalmo...
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Reader Question:
Avoid EO Denials With Proper 92225-92226 Use
Question: I just got a denial on 92226. I think I might be using this code incorrec...
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You Be the Coder:
Levator Resection With Blepharoplasty
Question: Our oculoplastic surgeon performed levator resection and blepharoplasty o...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 9
Retinal Procedures:
Initial, Subsequent, Bilateral, Unilateral: Here's How to Clear Up Your Retina Coding Myths
Tip: CPT® code 67112 isn’t always for subsequent repairs. With thousands of ...
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ICD-10:
More Changes Coming for Visual Disturbances Dx
H53 family also covers visual field defects, color vision deficiency, and night blindness....
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ICD-10:
5 FAQs Quell Confusion on CMS's Latest ICD-10 Announcement
The one- year grace period for ICD-10 claims applies to Medicare only. If CMS’s ...
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Reader Questions:
Don't Report ICG Dye Separately for 92240
Question: One of our physicians wants to know if we can bill for indocyanine-green ...
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Reader Questions:
Distinguish Facility vs. Non-Facility Fees
Question: Can you please explain whether we should use the facility global fee or t...
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Reader Questions:
Know Documentation Requirements for Provocative Glaucoma Tests
Question: What testing and documentation do I need to bill for 92140 (Provocative t...
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You Be the Coder:
Glaucoma Screenings
Question: A Medicare patient presented for a glaucoma screening. He had no personal hist...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 8
Office Visits:
Here's How to Make the E/M vs. Eye Codes Choice Simple
You’ve got two options for coding office visits – here’s how to decide...
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Eye Code or E/M Code?
Consult this guide before picking a code for your next office visit. E/M Codes: ...
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ICD-10:
Check These Visual Disturbances Dx Changes
Tip: Some codes ranges have been expanded to show laterality. Like many of the current...
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CCI Update:
CCI 21.2 Changes Your Ectropion, Entropion Repair Coding
Modifier indicator may let you override bundling. The latest set of Correct Coding Ini...
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Reimbursement:
January Could Bring Changes for Incident to Services
New Medicare Physician Fee Schedule proposal brings pay raise next year. For the first...
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Reader Question:
Choosing New vs. Established Patient Codes
Question: What is the difference between a new and established patient, for office ...
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You Be the Coder:
Second Cataract Removal Within Global
Question: On June 1, our ophthalmic surgeon performed an extracapsular cataract rem...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 7
Contact Lenses:
Contact Coding Story Doesn't Stop at 92310
Get your deserved reimbursement for medically necessary lenses. Seasoned ophthalmology...
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ICD-10:
New Dx Codes Add Laterality for Most "Other Specified" Glaucoma
H40.89 will cover many “other” conditions. Starting Oct. 1, 2015, ophthalm...
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Gonioscopy:
Are These Myths Holding Back Your 92020 Claims?
Get to know the post-op, bilateral billing rules for gonioscopy. Gonioscopy may not be...
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Reader Questions:
Billing EO Separately? Read This First
Question: A patient reports flashes and floaters but the ophthalmologist does not find e...
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Reader Questions:
Modifiers Key to Successful E/M, VF, Temp Plug Claim
Question: A patient came in for visual field (VF) tests. During the same visit, the...
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Reader Questions:
Don't Charge 92250 Without Diagnostic Basis
Question: If you perform 92250 (Fundus photography) on a patient with diabetes and ...
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You Be the Coder:
Testing for Plaquenil Effects
Question: When the ophthalmologist performs OCT on a patient using Plaquenil for rh...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 6
AMD:
Coding Age-Related Macular Degeneration Tests Separately? Read This First
Know which type of AMD the patient has for complete coding success. Age-related macula...
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Coding Quiz:
Test Your Intraocular Lens Coding Prowess
What would you do in these scenarios? Each year, surgeons implant more than 6 million ...
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ICD-10:
H40.6 Family Holds Key to Corticosteroid-Induced Glaucoma
Tip: Each character in the ICD-10 code tells you something specific about the condition....
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Coding Quiz Answers:
Read Our Expert Solutions to the IOL Coding Scenarios
Every cataract procedure includes an IOL – but there are situations where separate...
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Reader Questions:
65205, 65222 Get It Done for Conjunctival, Corneal FBRs
Question: A patient reported with a foreign-body sensation after mowing the lawn an...
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Reader Questions:
Don't Get Zapped by ERG Bilateral Rules
Question: Can I code an electroretinogram bilaterally? Colorado Subscriber Answ...
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Reader Questions:
Focus on Payer Rules Governing 51 Use
Question: I have heard our coders saying that they don’t need to attach modif...
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You Be the Coder:
Tracking Glaucoma and DR Progress
Question: The ophthalmologist is monitoring a patient who has glaucoma and diabetic reti...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 5
Retinal Detachments:
67101-67113 Primer: Know What's Involved in Procedures to Correctly Code Claims
Tip: 67101 and 67105 include one or more repair sessions. Retinal detachments are almo...
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ICD-10:
Close In on New Dx Codes for Primary Angle-Closure Glaucoma
Hint: Know the significance of each character to identify most accurate code. In ICD-1...
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Reader Questions:
Look for Clinical Circumstances to Code Bleph and Ptosis Repair
Question: Can CPT® codes 15823 and 67904 be billed together? Would I need a mod...
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Reader Questions:
Use 371.43 for Calcific Band Keratopathy
Question: I have a patient with extreme calcific band keratopathy. Is there a more ...
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Reader Question:
Report 92100 Only Once for Multiple IOP Tests
Question: How would I code for four appointments for a single patient to map intrao...
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Reader Question:
Don't Fear ICD-10 Transition
Question: I’ve been told that ICD-10 will be nearly impossible to use because...
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You Be the Coder:
Corneal Filaments
Question: Is removal of corneal filaments billable? And if so, what code would you ...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 4
CCI Update:
CCI 21.1 Debuts Bundles for Anterior, Intravitreal, Subconjunctival Injections
Thinking of reporting an injection separately from a cataract removal? Think again...
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ICD-10:
Explore H44 for More Disorders of the Globe Dx
Degenerative myopia, siderosis diagnoses will specify affected eye. In our last issue,...
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E/M Coding:
3 Ways Comparative Billing Reports Can Rescue Your Coding
Use the CBRs as springboards to gauge your accuracy. Your MACs are reviewing the most ...
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Part B Payment:
Congress Votes to Overhaul Part B Payments
You’ll no longer face potential payment drops at the beginning of each New Year. ...
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Billing:
These 6 Tips Will Transform Your Accounts Receivables
Coordinate back office and front desk staff to keep cash flow positive. You know you&rsqu...
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Reader Questions:
No Unusual Documentation Needed for Large Bifocal Segs
Question: I’m really confused about codes V2219 and V2319 for Medicare patient...
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You Be the Coder:
Repeat Focal Laser
Question: IA patient returns during the 90-day postoperative period of a focal l...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 3
Ophthalmic Trauma Care:
Focus on 65205-65222 and 65270-65286 for Eye Injury Claims
Tip: Foreign body removal can be included in the corneal repair. Although it’...
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ICD-10:
Zoom In on H44 Codes for Endophthalmitis, Other Disorders of Globe
New diagnosis codes break condition down by left, right, both or unspecified eyes. Whe...
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Reimbursement:
Medicare Physician Fee Schedule: Watch for Possible April Pay Cut
But an act of Congress can save the day. So far this year, you should be experiencing ...
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Compliance:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20...
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Reader Questions:
Clear Up Patient Medicare Confusion
Question: We have a patient asking why she has to pay anything when we accept assignment...
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Reader Question:
E/M, Eye Codes Don't Include Refraction Services
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscrib...
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You Be the Coder:
Trabeculectomy Suture Removal
Question: I am trying to bill for the removal of sutures the ophthalmologist placed duri...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 2
Strabismus:
Is One of These Strabismus Myths Making Your Coding Askew?
Keep on top of bilateral rules, diagnoses, and separate procedures to keep your claims s...
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ICD-10:
Q10.- Has Your Congenital Eyelid Malformations Dx Answers
Get ready: Implementation date is still set for this October. Unlike many of the ICD-1...
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Testing:
Don't Let Unanswered IOL Power Calculation Questions Cloud Your Reimbursement
Read on for our expert answers to these 76519 and 92136 head-scratchers. Calculating i...
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Medicare Errors:
Let CERT Findings Focus E/M Claims
Avoid key documentation mistakes that cost you pay. Imagine if you lost 10 percent of ...
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Reader Question:
Add to Your ICD-10 Know-How
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes ...
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Reader Question:
Don't Bill Patient for Records Transfer
Question: Our practice discharged a patient due to non-payment, and one week later a ...
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You Be the Coder:
Abandoned Photocoagulation
Question: After discussing the risks and benefits of both cryotherapy and photocoag...
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Ophthalmology And Optometry Coding Alert - 2015; Volume 18, Number 1
Blepharoplasty:
Think 15820-15823 and 67901-67908 Are Interchangeable? Think Again
Read these frequently asked questions before coding your next eyelid procedure claim. ...
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Reimbursement:
Final Fee Schedule Confirms Phasing Out of Global Periods
Ophthalmology practices, prepare for a 2 percent cut to Medicare payments. When CMS annou...
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ICD-10:
Keep Your Eye on Revised Retinal Detachment Diagnosis Codes
Substitute these H33.--- codes for the 361.xx ICD-9 codes. As with many of the diagnos...
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Billing:
Get Comfortable with Unruly Consolidated Billing Rules
Uncover who, what, and when to bill so you get your money. Knowing whether your skille...
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Reader question:
Know This 375.15 & 370.21 Distinction
Question: Can 375.15 and 370.21 be used interchangeably? When would one be the pref...
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Correction
The answer to the “You Be the Coder” question in Opthalmology Coding Alert V...
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Reader Question:
Appeal Is an Option When Patient Prevents Timely Filing
Question: We have a timely filing concern. Our physician saw a patient who didn&rsq...
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You Be the Coder:
Unilateral OCT
Question: We performed an OCT on a patient’s left eye, and filed the claim wi...
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