Advanced Search

Ophthalmology and Optometry Coding Alert

Ophthalmologists Will Be Reimbursed for Visudyne

Published on Sun Apr 01, 2001

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.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ophthalmology and Optometry Coding Alert

View All