Ophthalmology and Optometry Coding Alert

Glaucoma Screenings:

S0620 or G0117? Let Form and Severity Drive Your Glaucoma Coding Choice

If the patient presents with no complaints, you must consider the exam 'routine.' With 18 plus options to sift through when coding a glaucoma visit, you need these simple guidelines to secure the insurer preferred code that lands payment, not denial. You have four options for coding glaucoma exams, depending on the payer, type and severity of the glaucoma. You are given a choice of using four ophthalmic visit or CPT codes (or "eye codes") (92002-92014, Ophthalmological services: medical examination and evaluation ...), 10 evaluation and management (E/M) codes (99201-99215, Office or other outpatient visit ...), two HCPCS S codes (S0620 and S0621, Routine ophthalmological examination including refraction ...) and two G codes (G0117 and G0118, Glaucoma screening for high risk patient ...), or possibly, a combination of these. Hidden trap: You cannot use any combination of these on the same day, experts warn. In coding any patient/physician encounter, your [...]
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