Ophthalmology and Optometry Coding Alert
No New Code Describes Paperwork
Question: I’ve heard that CPT® has a new code for reviewing records separate from an appointment. Is this true? If so, what do we need to know before reporting it?
Answer: CPT® 2013 doesn’t include new codes for records review, but already has three codes in place for those situations. The most helpful option for ophthalmologists for extensive record review is 99358 (Prolonged evaluation and management service before and/or after direct [face-to-face] patient care; first hour). Code 99358 applies to non face-to- face services of 30 to 75 minutes. Be sure to associated and bill code 99358 with a face-to-face associated E/M visit. Careful, complete documentation of time spent is critical. Medicare and most payers do not pay for these services that are non face-to-face.
In the evaluation of E/M visit, there are pre-, intra-, and post-service work components that are valued. Pre-service work includes standard record review.
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Ophthalmology and Optometry Coding Alert
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