Ophthalmology and Optometry Coding Alert

Question: Our office sees a lot of workers'comp claims, usually for things like foreign-body removal. Should I code any differently for workers'comp claims?

Pennsylvania Subscriber

Answer: Generally, no. However, you should be aware that not every state uses current-year CPT codes.

You may get denials or experience delays if you're using new codes and your workers'comp carrier isn't up-to-date. It's best to ask your state carrier or check the Web site for the appropriate CPT codes to use.

And, it's important to use E codes. Of course these codes will never be the primary diagnosis, but they're important because they complete the picture of the patient's injury, treatment and claim. Patients may have more than one workers'comp claim open and in the system. An E code indicates the external cause of injury, such as E849.3 (Place of occurrence; industrial place and premises), and can help the carrier to differentiate between the claims and get them paid faster.

Hint: Workers'comp programs are usually run by your state's Department of Labor, which may be able to help you locate a Web site or phone number. To search for state Web sites, go to www.workerscompensation.com/ or www.comp.state.nc.us/ncic/pages/all50.htm.

For federal program information: www.dol.gov/esa/regs/compliance/owcp/fecacont.htm.

For railroad program information: www.brs.org/felainfo.htm.

- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, health management consultant and national seminar leader for McVey Associates; Raequell Duran, president of Practice Solutions, Santa Barbara, Calif.; Wayne Miller, attorney with Compliance Law Group in Woodland Hills, Calif.; and Gary E. Matthews, president of Physicians HealthCare Advisors LLC in Atlanta.