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Ophthalmology and Optometry Coding Alert

Office Visit Coding:
Choose Between E/M, Eye Codes With These Tips
There's no simple answer to find which code to use, but documentation will drive your choi... Read more
Clip And Save:
E/M Codes or Eye Code?
One method that some practices use to select between eye codes and E/M codes is to read th... Read more
IOL Power:
Bust These Myths About IOL Power Calculations
Can't wrap your head around the rules for 76519 and 92136? Read on. In light of advanceme... Read more
E/M Coding:
5 Quick E/M Tips From One Part B MAC
Equating thick documentation to a high-level E/M? Think again. If you're tired of hearing... Read more
Reader Question:
Which Code Describes Strabismus Surgery?
Question: Our surgeon performed a resection procedure on two horizontal muscles for strabi... Read more
Reader Question:
Evaluate How to Report Cryothermy Vs. Diathermy
Question: We are confused by the differences between cryothermy and diathermy from a codin... Read more
You Be the Coder:
Know What Determines Cosmetic Blepharitis Status
Question: How do we know when a blepharitis procedure is considered cosmetic? Codify Subs... Read more
CPT® 2018:
Latest CPT® Edition Offers New Eyelid Lesion Removal Codes
Plus: Be ready for changes to the descriptor for visual evoked potentials. Even though 20... Read more
ICD-10:
5 Tips Help You Perfect Your Use of New Eye Care Diagnosis Codes
Hint: Create new templates to help guide your specificity. Eye care practices have been u... Read more
Compliance:
5 Quick Tips Help You Avoid Fraud Accusations
Remember: Collect all deductibles, copays When this time of year rolls around and you're ... Read more
Reader Question:
Use Patient Intake Form as ROS Guide
Question: Our physicians often can't bill a higher E/M code because they don't have a... Read more
Reader Question:
Include Conference in E/M Service
Question: Our ophthalmologist treated a patient with severe eye injuries due to a car... Read more
Reader Question:
Look to 66762 for Iridoplasty
Question: One of our physicians performed a pupilloplasty. What is the correct code f... Read more
You Be the Coder:
Contact Insurers for Time Verification
Question: In your article about glaucoma screenings last month, you noted that one of... Read more
Screenings:
Master These Glaucoma Screening Musts — With Details Straight From Medicare Reps
Not sure who qualifies for the screening codes? Find out here. Your eye care practice is ... Read more
Non-Physician Practitioners:
Don't Forget Modifier SA on NPP Claims for This Major Payer
Non-physician practitioner performing an E/M? Modifier SA is critical now. Reporting E/M ... Read more
Compliance:
Medical Biller Heads to Prison for Fraudulent Claims
You thought billers couldn't be held responsible? Think again. Medical coders and billers... Read more
Reader Question:
Know the Vision Plan Details Up-Front
Question: We've been having problems with patients who tell us about their medical in... Read more
Reader Question:
Does Missing Organ Count Toward ROS?
Question: If the physician examines a patient who has had an organ removed, can we st... Read more
Reader Question:
Nail Down Global Periods
Question: We saw a patient twice in the same week - on the first visit, the doctor in... Read more
Reader Question:
Know How to Perform EHR Risk Analysis
Question: In last month's issue of Ophthalmology and Optometry Coding Alert, your art... Read more
You Be the Coder:
Take A Second to Code Femtosecond Laser
Question: Our physician recently started using a femtosecond laser during keratoplast... Read more
Part B Fee Schedule:
Latest Fee Schedule Proposal Could Mean Big Changes to E/M Documentation
The agency seeks feedback on how these changes would impact your practice. With summer ab... Read more
Get to Know How Else the Fee Schedule Could Impact Your Pay
Fee changes won't be too dramatic for eye care practices if proposals are adopted. CMS's ... Read more
Modifiers:
One Blue Cross Insurer Just Cut Modifier 25 Payments in Half
If you bill claims to Independence Blue Cross Blue Shield, watch out for reductions. Eye ... Read more
Electronic Health Records:
OIG Is Now Going After EHR Vendors — Is Your Program Secure?
In landmark settlement, software vendor faces $155 million in paybacks. When your electro... Read more
Reader Question:
Program EHR to Help With Smooth Diagnosis Coding
Question: Our providers use the superbill to select their ICD-10 codes, but we only h... Read more
Reader Question:
Head Toward H44.4 Series for Hypotony Dx
Question: Which ICD-10 code applies to a diagnosis of hypotony? Codify Subscriber A... Read more
Reader Question:
Stay on the Right Side of Co-Management Challenges
Question: We recently contracted with an optometry practice for co-management - our s... Read more
Reader Question:
Avoid Blanket ABNs
Question: Our receptionist asks Medicare patients to sign ABNs for almost every servi... Read more
Reader Question:
Let Modifier Q6 Be Your Locum Tenens Friend
Question: One of our physicians is taking maternity leave next month, and a locum phy... Read more
You Be the Coder:
Do Eye Exam Codes Have Frequency Guidelines?
Question: My ophthalmologist documented a comprehensive office visit for an establish... Read more
ICD-10-CM:
You'll Find New Myopia, Blindness Codes on Oct. 1
CMS has released the finalized list of 2018 diagnosis codes. Eye care coders hoping for s... Read more
Breaking:
For These Eye Procedures, Report 99024 for Postop Visits
Certain states now require this new procedure. If you’re used to including post-ope... Read more
Modifiers:
Modifier 25 Misuse Leads to Six-Figure Settlement for This Ophthalmologist
At issue: Whether to report intravitreal injections with E/M services. Some eye care prac... Read more
Billing:
Collect More Reimbursement by Correcting This Big Issue
Following up on your claims is just as important as submitting them. As ophthalmologists ... Read more
Reader Question:
Know the New Taxonomy Subspecialty Codes
Question: When can we start using the new retina and glaucoma taxonomy specialty desi... Read more
Reader Question:
PLI Is Typically An Out-of-Pocket Expense
Question: We have a patient getting cataract surgery who will require a premium lens ... Read more
You Be the Coder:
Know How to Bill E/M Visits When the Patient Isn't Present
Question: We had a patient’s son present to talk about his mother’s glauc... Read more
ICD-10-CM:
New Proposed Codes Could Change Your Blepharitis Coding in October
Eyelid cancer, brow ptosis are also diagnosis codes to watch. Blepharitis coding could be... Read more
Inpatient Coding:
What You Don't Know About Hospital Care Coding Could Hurt You
Consider these 4 quick tips to nail down the right code for inpatient visits. Many eye ca... Read more
Contact Lens Services:
Look to 92072 With H18.6x When Fitting Keratoconic Lenses
Follow this strategy and earn $136 for each contact lens procedure. Reporting the typical... Read more
Reader Question:
Look to 92250 for Fundus Photographs
Question: Our ophthalmologist uses a fundus camera frequently and we’ve been in... Read more
Reader Question:
Know the Rules for 67110 and 67141
Question: Our doctors are retina specialists. One of the physicians performed a pneum... Read more
Reader Question:
Know the YAG Global Rules
Question: A patient of ours is in the global period for a YAG laser procedure. She ca... Read more
Reader Question:
Take Your Work Home Without Revealing PHI
Question: Thank you for last month’s article about HIPAA (This Clinic Got Hacke... Read more
You Be the Coder:
How Many Codes Apply to Serial Tonometry?
Question: Our ophthalmologist treated an acute glaucoma patient and performed serial ... Read more
Revenue Booster:
Report the 5 Most-Frequently Billed Eye Care Codes With Ease
These quick tips will ensure that you’re bringing in accurate income for these commo... Read more
Check Out Optometrists' 5 Most Frequently-Billed Codes
Three of the five most-commonly reported codes are different from ophthalmologists’.... Read more
ICD-10:
Test Whether You Can Fill in the ICD-10 Blanks on This Eye Care Note
This quick quiz will help you determine whether you can assign the right diagnosis codes. ... Read more
Patient Privacy:
This Clinic Got Hacked, Had to Pay $400K HIPAA Breach Penalty
Ensure that you don’t face a similar fate — keep your practice protected. Ima... Read more
Reader Question:
Don't Use 99211 As A Catch-All
Question: Our ophthalmologist evaluated an established patient for dry eyes and offer... Read more
Reader Question:
Use Care When Swapping Between 1995, 1997 Guidelines
Question: I know I can choose either the 1995 or the 1997 documentation guidelines fo... Read more
Reader Question:
Keep 60-Day Overpayment Threshold at Top of Mind
Question: Our MAC says we must return any overpayments to federal health programs wit... Read more
You Be the Coder:
This Payer Has New Exam Tallying Rules
Question: Can you explain the differences between the expanded problem-focused exam a... Read more
E/M Coding:
Get the Scoop on These E/M FAQs, With Answers Straight From Medicare
If you lean toward eye codes because you fear E/M coding, this article is for you. Eye ca... Read more
Cataract Surgery:
Auditors Announce Near-Nationwide Reviews of Cataract Claims
Here’s what you can do right now to ensure you’re coding properly. No coder w... Read more
The RACs Are Also Reviewing These Issues Applicable to Eye Practices
Although cataract surgeries are the most pressing open RAC issues, these auditors have ann... Read more
ICD-10:
Read Details of Eye Irritation to Pinpoint Diagnosis Code
Documentation must differentiate between types of irritation before you can select the rig... Read more
Reader Question:
Check Documentation When Surgical Approach Changes
Question: Our ophthalmologist performed a blepharoptosis repair using the frontalis m... Read more
Reader Question:
Avoid Unlisted for Corneal Topography
Question: We have a new physician who performs corneal topography, which our practice... Read more
Reader Question:
External Cause Codes Can Support Your Claims
Question: Is it important that I use the “External cause” codes in ICD-10... Read more
Reader Question:
Nail Down Symptoms for Nonspecific Complaints
Question: Our optometrist has a habit of writing “visual disturbance” on ... Read more
You Be the Coder:
Which Condition Should ICD-10 Code Reflect?
Question: How should I bill Blue Cross Blue Shield for a routine exam with the diagno... Read more
Correct Coding:
Don't Worry About Revenue ® Code Accurately And the Money Will Follow
This expert’s advice might contradict everything you know — but it will help y... Read more
Time-Based E/M Coding:
Time is Money ® If You Document Properly
Avoid the ophthalmological services codes when time is on your side. The great debate ove... Read more
Surgical Packages:
Go Global With This Quick Eye Care Surgical Package Primer
Tip: Even ‘XXX’ globals will impact your income. Global periods are often tho... Read more
Clip And Save:
Don't Include These 10 Services in Your Global Package
In most cases, you can report these services separately and collect for them. When you&rs... Read more
Reader Question:
Don't Ditch Those Medical Records
Question: Our office has converted to digital records and we are thinking of shreddin... Read more
You Be the Coder:
Moderate Sedation Adjustment Impacts 66720
Question: We’ve noticed that payment for 66720 (Ciliary body destruction; cryot... Read more
Medical Notes:
Documentation Errors Plague Retinal Photocoagulation Claims
Remember: Even an unsigned visit note can cost you over $300. Just because you’re g... Read more
ICD-10 Quiz:
Test Your Eye Care Diagnosis Coding Knowledge With 5 Quick Questions
Unsure of how to report Brown’s sheath syndrome? Check these options. Most eye care... Read more
Eyelash Removal:
Learn 2 Myths And 1 Reality About Coding Epilation for Trichiasis
Per eye, per lash, or per lid? Know the right way to code. An eyelash growing in toward a... Read more
Incident-To:
5 Quick Tips Help You Finesse Incident-to Claims
Want 15 percent more reimbursement? Make sure you memorize these rules. Billing your serv... Read more
Reader Question:
Medicare Doesn't Mess Around With Timely Filing
Question: One of our patients visited our office for a visit but didn’t have hi... Read more
Reader Question:
Some Encounters Aren't Billable
Question: A new patient presented with a suspected ophthalmic lesion, and the nurse t... Read more
Reader Question:
React Quickly After HIPAA Breach
Question: Our office manager thinks we need to contact the authorities after her lapt... Read more
You Be the Coder:
Prep for Potential Avastin Denials
Question: I’m suddenly getting denials from Aetna for Avastin. Are you aware of... Read more
Coding Errors:
Use Expert Examples to Avoid These Common Eye Coding Errors
 CMS finds startling 13.5 percent error rate among 2016 eye procedures — don&rs... Read more
Optometrists See Even Higher Error Rate Than Ophthalmologists
Optometry specialists were not immune to the CERT report’s glaring spotlight, and wh... Read more
Operative Note Coding:
Can You Code These Operative Reports?
Get the answers — straight from experts at the AAO conference. Coding an ophthalmol... Read more
CPT® 2017:
Are You Reporting the 2017 CPT® Codes Correctly? Check This Primer to Find Out
Don’t miss these new Category III codes. Now that the calendar has turned to the Ne... Read more
Check Payer Policies for Updates
Although you’ve probably thought to reference your payer policies regarding new CPT&... Read more
Reader Question:
Look to 'H' Code for Glare Sensitivity
Question: We used to report 368.8 (Other specified visual disturbances) as the primar... Read more
Reader Question:
Know How to Code for Negative Findings
Question: A 72-year-old patient presented with high intraocular pressure in the right... Read more
You Be the Coder:
Know How to Review MDM
Question: We used to report only ophthalmological services codes, but now our doctors... Read more
Compliance:
Avoid These 2017 Audit Hot Spots by Amping Up Your Documentation — Here's How
Plus, how to keep your 66982 claims squeaky clean. In 2017, the spotlight may be on yo... Read more
Coding Quiz:
Can You Pass the OCS Test? Find Out
Test your FBR, Epilation & YAG coding know-how. These are the top three questions ... Read more
Revenue Builder:
Ethically Maximize Your Reimbursement for Low Vision Evals
Hint: Choose E/M codes over eye codes for higher pay. Ophthalmologists who provide low... Read more
Reader Question:
Multiple Global Periods May Mean Multiple Modifiers
Question: A patient had cataract surgery in her right eye on August 4th. Surgery wa... Read more
Reader Question:
Adding Telemedicine? Don't Forget to Update Your Coding, Too
Question: Next month, one of our ophthalmologists will begin conducting remote diab... Read more
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