Ophthalmology and Optometry Coding Alert

Discovering common coding errors is the first step to correcting them. Overcoding and undercoding contributed to more than $17 million in projected improper Medicare payments in 2008, according to the most recent Comprehensive Error Rate Testing (CERT) results. You can prevent errors and plug revenue sinkholes to guarantee your practice's correct reimbursement using these leveling guidelines: Don't Sell Your E/M Levels Short Undercoding takes place when a practice bills a level of service at a level lower than what the patient's history, examination, and decision making support, says Carla Mack, OD, Director of Clinics at the Ohio State University College of Optometry in Columbus. A practice may record and bill a level-two established patient E/M visit (99212, Office or other outpatient visit for the evaluation and management of an established patient ...) when the patient history, examination, and decision making support an E/M level three (99213). Example: An established patient [...]