Ophthalmology and Optometry Coding Alert

Question: I bill post-op visits with CPT code 99024 and charge $0. Sometimes it goes through, but today I had a status message that BCBS rejected my claim with three services of post-op visits stating: "at least one line item charge amount must be > than zero." I should not be charging anything for the post-op visits, so what do I do?

Washington Subscriber

Answer: Don't bother billing out the zero-dollar post op services with 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason[s] related to the original procedure). You should delete the claims and disregard the rejected claims.

Request assistance from your software support technicians on setting up your system to stop billing for zero-charge services. Blue Cross Blue Shield (BCBS) does not want to track non charges. In fact, most payers only want to process claims that indicate a charge for services rendered.

Suggestion: The patient's medical record should contain documentation of any post-op visit. You may also want to post the charge to your system for internal audit and tracking purposes.

Your software should then allow you the option of not sending the claim for zerocharge services. This would work the same as services entered as "N/C."

Money saver: If you are paying your clearinghouse by the claim, you are wasting your money as well. Set up an agreement with your clearinghouse that they will not bill out -- or charge you for -- zero-dollar claims.

-- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, consulting manager for Pershing, Yoakley, and Associates in Clearwater, Fla.