Diagnostics:
Appending Modifier 50 to 92250? Not So Fast
Published on Mon Apr 26, 2010
4 strategies help you snap up your rightful fundus photo pay with bundling, dx know-how.Adding too many -- or too few -- diagnosis codes to your fundus photography claim is a guaranteed way to invite denials or delayed payment. Whether you're selecting CPT or ICD-9 codes, you need to follow these quick tips to match your codes to your documentation and your payer's rules.1. Show Medical Necessity by Not Overdoing Dx Codes Reporting a wrong -- or irrelevant -- diagnosis code for fundus photography (92250, Fundus photography with interpretation and report) is a common slip-up. Be sure you link only the appropriate diagnosis with the procedure.Example: The ophthalmologist performs a comprehensive ophthalmological service such as 92004 or 92014, and finds that the patient has cataracts (366.19, Other and combined forms of senile cataract) and macular degeneration (362.50, Macular degeneration [senile], unspecified). He orders fundus photos for the macular degeneration and documents an interpretation and [...]