Ophthalmology and Optometry Coding Alert
Ophthalmoscopy
Ohio Subscriber
Answer: A routine ophthalmoscopy is a service component of intermediate and comprehensive ophthalmological services (92002, 92004, 92012, 92014) per the instructional notes under the ophthalmoscopy section in the current CPT manual. A routine ophthalmoscopy is one that is performed without a justifying sign, symptom or known condition (e.g., dilating and performing an indirect examination as part of a comprehensive visit even though there is no reason to believe that patient may have a problem in the posterior pole).
An extended ophthalmoscopy is code 92225, which includes a retinal drawing with interpretation and report, for the initial extended ophthalmoscopy and code 92226 for a subsequent extended ophthalmoscopy. This service is separately billable when there is a reported sign or symptom or a known diagnostic condition that would make the service reasonable and necessary. Many carriers have specific requirements for the drawing, such as the number of colors to be used.
Ophthalmology and Optometry Coding Alert
- You Be the Coder:
Modifiers -25 and -57
Question: The doctor saw the patient in the office after she had fallen and cut [...] - Get Reimbursed for the Removal of Lens Fragments
After cataract surgery, patients may notice floaters or spots in their vision that they have [...] - Watch ICD-9 Codes When Coding Multiple Visits
ICD-9 codes can make or break the acceptance of a claim. Coding a patient visit [...] - Code Punctum Snip/Biopsy Visits For Maximum Return
A patient came in for a punctum snip incision 68440* (snip incision of lacrimal punctum) [...] - Lash Epilation Clarified:
Watch Your Local Policies
The importance of local policies when it comes to Medicare cant be stressed enough. Without [...] - News Brief:
New Code Will Boost Pay for Complicated Cataract Surgery
As of CPT 2001, ophthalmologists will have a new CPT code to use for coding [...] - Compliance Tip:
No Standing Orders Allowed for A-scans
An ophthalmologist may want to see fundus photos or A-scans on a regular basis. To [...] - Reader Question:
-YB Modifier
Question: Is the -YB modifier billable and payable on 92235 (fluorescein angiography [includes multiframe imaging] [...] - Reader Question:
GDX
Question: Is there a code for interpreting a GDX?
New York Subscriber
Answer: According to the current [...] - Reader Question:
Keratoconus
Question: How do you code keratoconus? We have been using 92310 for fitting and 93010 [...] - Reader Question:
Low Vision Exams
Question: Are there specific CPT codes for low vision exams?
Florida Subscriber
Answer: The two CPT [...] - Reader Question:
Postsuture Removal
Question: Although all coding seminars state that postsuture removal is covered in the procedure, I [...] - Reader Question:
Injections
Question: If 67025 and 67038 are performed on the same day, what is the proper [...] - Reader Question:
Ophthalmoscopy
Question: What is the difference between routine and extended ophthalmoscopy? Is routine ophthalmoscopy already included [...] - Reader Question:
Retina Tomograph II
Question: We recently purchased the Retina Tomograph II. I know that the procedure code is [...]
