Ophthalmology and Optometry Coding Alert

Tip: You can schedule a second office visit -- but beware this coding stipulationYou know the routine: A patient shows up for an exam, but he won't let the ophthalmologist dilate his pupils that day. Whatever the reason -- time, the drive home, etc. -- you're stuck trying to find the best way to report a dilation at a separate visit. Most Medicare carriers assume that a dilated fundus exam will be a part of any comprehensive eye exam you perform and bill with 92004 (Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, one or more visits) or 92014 (Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, one or more visits), says Raequell Duran, CPC, president of Practice Solutions, a coding, compliance, and reimbursement consulting firm in Santa Barbara,Calif. Without dilation, you cannot perform the [...]