Ophthalmology and Optometry Coding Alert

Starting Jan. 1, you'll have to start reporting the new codes immediately CMS has scrapped the 90-day grace period you once had for implementing new HCPCS and CPT codes - which means you had better be ready to start using them now if you want your claims paid.

The new grace period rule kicked in when the 2005 CPT and HCPCS codes became effective on Jan. 1, says Krystin Keller, billing manager at Five Points Eye Care Center in Athens, Ga.

New codes for 2005 include:
   66711 - Ciliary body destruction; cyclophotocoagulation, endoscopic
   76510 - Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter. CPT has also revised 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 2005 edition of CPT Changes: An Insider's View explains the changes: "The ophthalmic ultrasound codes have been revised to distinguish unique services by separating out B-scan probe (76512) from diagnostic quantitative A-scan (76511), to reflect the differences in difficulty and time required to perform this procedure."

Code 76511 describes the quantitative diagnostic A-scan done at a few centers to manage intraocular tumors. Code 76512, the non-quantitative A-scan, "is built into some of the B-scan instrumentation, and is not related to the diagnostic A-scan," CPT Changes says. "Code 76510 has been added to describe performance of both a B-scan and quantitative A-scan performed during the same patient-physician encounter."

For complete information on CPT changes for ophthalmology practices in 2005, see "CPT 2005 Update: Cyclophotocoagulation Coding Could Get Easier Next Year" in the October 2004 Ophthalmology Coding Alert.