Ophthalmology and Optometry Coding Alert

Documentation, modifiers, and knowing your bundling rules can be worth nearly $45 each time.There may be just one code that describes optical coherence tomography (OCT) optic nerve imaging procedures, but that doesn't mean your coding will always be cut-and-dried.Follow these four steps when reporting 92133 (Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve), and you'll avoid most of the common coding pitfalls.1. Rely on Documented Order and NecessityMany Medicare carriers will cover 92133 annually for glaucoma or glaucoma suspects (365.00-365.9), every six months for low tension glaucoma (365.12), and more frequently based on the patient's specific circumstance. For this reason, the diagnosis is key to getting reimbursed.You should also check the documentation for the reason the optometrist orders the diagnostic OCT. The reason stated in the patient's record has to demonstrate medical necessity for payers to reimburse you on 92133.Example: A patient [...]