Ophthalmology and Optometry Coding Alert

Reporting same-day A-scans and B-scans may also be simpler, experts say

With just over three months to go before the new CPT codes take effect on Jan. 1, coders are eagerly collecting every hint as to the nature of the new codes.

Luckily, coding experts have learned many of the new codes. They caution that the new codes are provisional and subject to change, so you shouldn't consider any of them official until you receive your 2005 CPT book. Nevertheless, this early information provides a valuable first glimpse of next year's codes to help you start preparing.

Many coders rejoiced when CPT introduced the add-on code +66990 (Use of ophthalmic endoscope [list separately in addition to code for primary procedure]) in 2003. The catch, however, says Sarah Jones, surgery scheduler for Alvarado Eye Associates in San Diego, is that CPT doesn't permit adding the code to 66710 (Ciliary body destruction; cyclophotocoagulation) - leaving coders with no clear way to report endoscopic cyclophotocoagulation (ECP).

That could change in January 2005, experts are reporting. CPT 2005 may add 66711 (Ciliary body destruction; cyclophotocoagulation, endoscopic) to the list of ciliary body destruction codes, coding insiders say. CPT may also revise the description of 66710, adding "trans-scleral" to differentiate the approach in that procedure from the endoscopic approach in 66711, experts say.

Previously, when an ophthalmologist used an endoscopic laser to treat the ciliary body, coders would have to report 65875 (Severing adhesions of anterior segment of eye, incisional technique [with or without injection of air or liquid] [separate procedure]; posterior synechiae) or 66982 (Extracapsular cataract removal with insertion of intraocular lens prosthesis [one-stage procedure], manual or mechanical technique [e.g., irrigation and aspiration or phacoemulsification], complex, requiring devices or techniques not generally used in routine cataract surgery [e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis] or performed on patients in the amblyogenic developmental stage) along with 66710, depending on the clinical circumstances, Jones says. Starting Jan. 1, however, if 66711 appears in your new coding manuals, that code alone would be appropriate to describe ECP. Report New Code for Same-Day A-Scan and B-Scan Look for another new code in CPT 2005, experts say: 76510 (Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter) is expected to make its debut in January. This should solve the dilemma coders face when ophthalmologists perform an A-scan and a B-scan on the same day.

CPT is also expected to revise the code descriptors for 76511 and 76512 in 2005 (changes in bold print):

 76511 - Ophthalmic ultrasound, diagnostic; quantitative A-scan only

 76512 - Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative   A-scan). The reported revised description for 76512 specifies that it includes a [...]