Ophthalmology and Optometry Coding Alert

As of July 1, 2001, ophthalmology coders should use HCPCS code Q3013 for Visudyne (per 15 milligrams), the drug used in ocular photodynamic therapy (OPT). Until then, continue to follow carrier guidelines and use J3490 (unclassified drugs).

HCFA issued program memorandum (Change Request 1549) on Feb. 26, 2001, instructing Medicare carriers to pay for OPT (67221) when billed with diagnosis code 362.52 (exudative senile macular degeneration). The change request is effective with services provided July 1, 2001, or after.

The memorandum also says carriers may require that fluorescein angiography (FA) be maintained in the patients file for audit purposes, but instructs them not to require an FA with each claim.