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Ophthalmology and Optometry Coding Alert
Ophthalmology and Optometry Coding Alert
Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 12
Cataract Mythbuster:
Yes You Can Collect More Money for Complex Pediatric Cataract Extractions
Determining what your insurers consider “complex” is key. Your practice pr...
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Revenue Booster:
Don't Know Your Lateral From Your Inferior Rectus Muscles? Strabismus Pay Might Elude You
Nail down your anatomic knowledge now and collect appropriately later. Orthopedic code...
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Patient Privacy:
Don't Let a Text Compromise Your Eye Practice's Security
HIPAA-compliant messaging helps practices maintain their patients’ privacy. You...
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Reader Question:
Know the IOL Rules
Question: A patient undergoing complex cataract surgery received an astigmatism-cor...
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Reader Question:
Consider Type of Telemedicine When Choosing Code
Question: Often, one of our ophthalmologists or qualified nonphysician practitioner...
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Reader Question:
Determine Conjunctivitis Details Before Selecting Code
Question: We reported H10.10 for a conjunctivitis case – which is what we&rsq...
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You Be the Coder:
Know When, How to Amend Notes
Question: Our office performed an audit prior to submitting our claim to insurance ...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 11
CPT® 2017:
Latest CPT® Edition Updates Retinal Repair Codes
You’ll also see changes to angiography reporting. Although it’s still Octo...
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Documentation:
CMS Finds Rampant Errors Among Blepharoplasty Claims
No visual field testing? No Medicare payment, latest compliance newsletter says. You m...
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Patient Privacy:
HHS Targets Small HIPAA Breaches for Increased Scrutiny
New focus could impact eye care practices that aren’t part of big health systems. ...
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Clip And Save:
Check This List to Ensure You're HIPAA-Compliant
As technology evolves, so should your HIPAA plan. When you first created your practice&r...
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Reader Question:
Know When Procedure Is 'Staged'
Question: We performed a retinal detachment repair on a patient, and the following ...
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Reader Question:
Know the Modifier 55 Rules
Question: Our ophthalmologist is seeing a patient for follow-up visits after anothe...
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You Be the Coder:
ABNs Can Protect You
Question: We haven’t customarily used advance beneficiary notices (ABNs) in o...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 10
Ask The Expert:
Use These Expert Answers to Code Your Next Retinal Surgery Chart
Can you accurately code retinal detachments? Read more to find out. When you look thro...
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E/M Services:
Can You Code This E/M Note?
Ensure that you aren’t making a $31 mistake in your ophthalmology charts. Would ...
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Medicare Isn't the Only Payer Scrutinizing Claims
Medicaid is also checking your coding prowess. The Medicare CERT report reveals the mo...
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ICD-10:
Look to 6th Digit for Most Hypotony Diagnoses
Cause of condition may ease your code selection woes. When your ophthalmologist sees a...
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Reader Question:
Look to Modifier 25 When Global Spans 10 Days
Question: When treating a new or established patient and then deciding to do a...
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Reader Question:
Will 'X' Mark the Spot for Claims Approvals?
Question: We had a patient present who fell from a ladder and hurt his eye. We were...
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Reader Question:
Strabismus Codes Are Unilateral
Question: Our ophthalmologist resected the lateral rectus muscles of both the patie...
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You Be the Coder:
Admit Code Will Elude You
Question: Our ophthalmologist admitted a patient to the hospital and asked the code...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 9
Compliance:
5 Co-Management Challenges You Should Know
Co-management is not, and should not be, an agreement to refer, experts say. From a pr...
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Modifier 25:
Medicare Could Make Modifier 25 Pay Difficult With These Eye Procedures
Fee Schedule proposal aims to revalue certain services when billed with modifie...
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HIPAA Compliance:
iPhone Breach Leads to Six Figure Settlement
Make sure your practice’s business associates stay on the right side of the law. ...
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Reader Question:
Corneal Repair Trumps Foreign Body Removal
Question: Our ophthalmologist removing a corneal foreign body, and then performed a...
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Reader Question:
Know When Time Is on Your Side
Question: Our ophthalmologist often spends nearly an hour speaking with patients wh...
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You Be the Coder:
Doctor Should Take Lead When Managing Annual Vision Benefit
Question: Our patient’s vision plan covers either contacts or glasses annuall...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 8
Correct Coding Initiative:
New CCI Edits Restrict Visual Screenings With E/Ms
Fortunately, you can use a modifier to separate the edits when warranted. Although mos...
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Revenue Builder:
Follow This Practice Administrator's Lead to Collect More of Your Fees
Hint: Requesting self-pay amounts before surgery makes all the difference. Chasing dow...
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ICD-10:
Let 'Z' Codes Support Your Ophthalmology Claims and Help Bring in Payments
These codes aren’t just to make your claims lengthier—they serve an importan...
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These Z Codes Can Make Your Claims Shine
Eye care practices that are unfamiliar with additional Z codes beyond the ones mentioned...
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Reader Question:
Modifier 24 Shouldn't Change Dx Choice
Question: Can you use modifier 24 when the surgery and the E/M with 24 have the sam...
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Reader Question:
Locum Tenens Physicians Have Time Limits
Question: We are planning to hire a locum tenens (LT) physician for an ophthalmolog...
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Reader Question:
OR-Treated Complication Leads to Modifier 78
Question: A patient returned to the operating room to treat a complication within t...
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You Be the Coder:
Look to Documentation for Diagnosis Code
Question: How can I find an acceptable diagnosis code for 76514 (Ophthalmic ultraso...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 7
Coding And Billing Trends:
5 Tips Help You Benchmark Your Way to Better Revenue
If you aren’t evaluating your ophthalmology practice’s trends, you won&rsquo...
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Clip And Save:
Here's Your Breakdown of Which Codes Ophthalmologists Are Reporting Nationally
Once you compare your practice’s benchmarking data over time, you may want to take...
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Check This Optometry Benchmarking Information
If your eye care practice employs optometrists, you should separately perform a benchmar...
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Revenue Builder:
Tackle Your Ophthalmology Practice Challenges With 3 Simple Tips
Positive reimbursement starts with effective communication, these experts say. Ar...
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ICD-10:
Forgetting Stage on Glaucoma Claims Could Cost You
Stay on top of the extended descriptors to ensure you can collect for your services. Y...
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Reader Question:
Modifier TC Is Your Friend for Split Visual Field Service
Question: A patient came to our practice for a visual field test. He didn’t s...
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Reader Question:
Not All NP Services Require Modifier SA
Question: Our ophthalmology practice employs a nurse practitioner (NP), and when sh...
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You Be the Coder:
Documentation Will Reveal Whether E/M Is OK
Question: Our ophthalmologist removed a foreign body from a patient’s eye. Ca...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 6
Contact Lenses:
Keep Lens Coding Focused by Avoiding These Myths
Cosmetic or medically necessary? Not all lens codes are created equal. Even in the mos...
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Modifiers:
Make the Code Fit the Procedure With Smart Modifier Use
But be careful: Know which eye modifiers have the power to affect your payments. Even...
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Practice Management:
Keep an Eye on Your Claims to Max Out Your Ophthalmologists' Pay
Keep your AR up-to-date with claim monitoring. You’re up-to-date on coding chang...
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Reader Question:
Amount of Material, Method Determine Vitrectomy Code Choice
Question: Our ophthalmologist performed a pars plana vitrectomy, removing lens frag...
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Reader Question:
Work This Plan for SNF Office Payments
Question: One of our ophthalmologists is treating a skilled nursing facility (SNF) ...
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Reader Question:
Recognize Breach Under HIPAA
Question: An employee at our ophthalmology practice accessed records for which he h...
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You Be the Coder:
Astigmatic Contacts
Question: Which code should we use for monthly replacement toric contacts? We have ...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 5
Cataract Surgery:
Keep Your Cataract Coding Solid With These Expert Tips
Documentation is key – and stay away from the “unspecified” codes. W...
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ICD-10:
Expanded Dx Codes Are Coming for Diabetes With Ophthalmic Complications
Also, look for new retinal vein occlusion, AMD, glaucoma, and amblyopia options. New a...
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Reader Question:
Look to 66986 for IOL Exchange
Question: The patient presents with a dislocated intraocular lens (IOL), which cann...
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Reader Question:
Make Sure Patients Understand EOB's Purpose
Question: We often get patients who call the practice with questions about their ex...
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You Be the Coder:
Second Retinal Repair
Question: A patient underwent a retinal repair in the right eye, then three weeks l...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 4
Glaucoma Coding:
Part II: Zoom In on Glaucoma Screening, Testing, Treatment Rules
Do you know which codes should only be used with Medicare patients? Last issue, we bro...
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Coding Quiz:
Keep Your Strabismus Coding Straight
Tip: It helps to know the anatomy of the extraocular muscles. How well do you know you...
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CCI Update:
CCI Lays Down the Law on IV Codes
CPT® 96361, 96366, 96367, 96368 bundles effect codes in virtually all specialties. ...
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Coding Quiz Answers:
Keep Unilateral Rules Straight for Strabismus Success
Two muscles in one eye does not equal one muscle in both eyes. So how did you do with ...
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Reader Question:
Determine If Bleph Procedures Are Cosmetic
Question: When our ophthalmologist performs blepharoplasty, I’m often not sur...
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Reader Question:
Foreign Body Sensation - But No Foreign Body?
Question: What is proper diagnosis coding if a patient comes in with a foreign-body...
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Reader Question:
Stick With Single Dx Code for Diabetic Retinopathy
Question: For a diagnosis of diabetic retinopathy with ICD-10 codes, do we still ha...
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Reader Question:
Correct EHR Entries As You Would Paper
Question: We are aware of how to correct a mistake on a paper medical record, but h...
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You Be the Coder:
Silicon Oil Removal Dx
Question: What ICD-10 code should I report for silicon oil removal? New Mexico Su...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 3
Glaucoma Coding:
Part I: Get Familiar With All the Angles to Focus Your Glaucoma Dx Coding
Understand who’s at risk, know the screening rules, and specify which eye is affec...
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Diagnostics:
Safeguard $80 Each Time by Knowing Fundus Photo Rules
There may be just one CPT® code, but diagnosis coding and bilateral rules could be p...
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Place of Service:
Use New POS Code for "Off-Campus" Services
Look for changes in payment coming soon for off-campus provider-based clinics. If your...
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Reader Question:
Medicare Won't Pay? Get ABN Anyway
Question: Are patients undergoing keratoconus workup or contact lens fitting still ...
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Reader Question:
Don't Try Low-Vision Codes on Medicare
Question: Our practice is considering dispensing low-vision aids. How should we cod...
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Reader Question:
Use Split Visit Rules to Duck 15 Percent Pay Cut
Question: I’ve heard nurse practitioners (NPs) and other providers talk about...
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You Be the Coder:
Non-Serial Tonometry
Question: Our ophthalmologist renders single-episode tonometry services on her pati...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 2
CCI Update:
Watch for Corneal Ring Segment, Collagen Cross-Linking Bundles
Tip: You can report a Column 2 code with a Column 1 code – but only under cer...
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Diagnostic Tests:
Part III: SCODI, FA, Fundus Photography, and Gonioscopy Round Out Your Diagnostic Coding Arsenal
Warning: Don’t get tripped up by tricky bilateral rules. In the last issue of Op...
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E/M:
Make Sure Your E/M Claims Aren't Part of the 14.6% Error Rate
NPP claims are part of the problem. Evaluation and management coding and “incid...
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Reader Question:
Single Code for Bilateral Pachymetry
Question: I’m trying to submit a claim for 76514 performed on both eyes, but ...
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Reader Question:
Beware Medical Records Rules
Question: We discharged a patient due to non-payment, and one week later a new surg...
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Reader Question:
Determine PFSH for E/M Choice
Question: I have a surgeon’s note for an office visit that clearly indicates ...
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You Be the Coder:
Endophthalmitis
Question: The ICD-10 description for endophthalmitis now says to “use additio...
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Ophthalmology And Optometry Coding Alert - 2016; Volume 19, Number 1
Diagnostic Tests:
Part II: Refraction, Topography, Visual Fields - Keep Your Diagnostic Test Coding On Point
Follow these expert tips for CPT® 92015, 92025, and 92081-92083. In the last issue...
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ICD-10:
H47 Family Holds the ICD-10 Answers for Optic Chiasm, Visual Cortex Disorders
Check detailed codes for side specificity. If you’re in a neuro-ophthalmology pr...
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Compliance:
OIG Recovered $3.35 Billion in 2015, Plans Scrutiny of Ophthalmology Services
Place of service errors also continue to be on the agency’s radar screen. Any am...
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Compliance:
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $...
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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:
Test EHR Functionality Frequently Post-Implementation
Question: What should our practice do to prevent unintended consequences from elect...
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Reader Question:
Don't Take Chart Amendments Lightly
Question: One of our physicians made mistakes on several charts and printed out new...
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You Be the Coder:
Focal Laser in Post-op Period
Question: On Sept. 15, the ophthalmologist performed focal laser surgery on the are...
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