Ophthalmology and Optometry Coding Alert
NPI Deadlines Still Loom -- Be Prepared
Question: Pennsylvania Subscriber Answer: Caution: If your carrier has asked you to resubmit information on its 855 enrollment form, proceed with particular caution. If you haven't yet submitted a new 855, your carrier may be paying your claims by virtue of a "temporary crosswalk match" that links your legacy number and NPI. But the carriers' upcoming maintenance of the provider enrollment system may soon throw a wrench into that temporary fix, leaving you in a situation with carriers suddenly rejecting all claims. To avoid this tripping point, get the 855 form in -- and communicate with your carrier to ensure the system picks up the corrections in a timely manner. Simply turning in the corrected 855 -- without following up with your Medicare carrier -- may not be enough. CMS has warned that the process of revising the enrollment data "can take a number of months to accomplish." Resource: Learn more about NPIs at http://www.cms.hhs.gov/NationalProvIdentStand. -- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla.
Ophthalmology and Optometry Coding Alert
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Cataract Removal With Vitrectomy
Question: One of our ophthalmic surgeons performed a vitrectomy (67005) for a vitreous prolapse diagnosis [...] - Reader Questions:
Don't Change Insertion Code by Plug Type
Question: Our ophthalmologist uses both temporary and permanent punctal plugs. Should I code differently for [...] - Reader Questions:
Use Paper as a Backup for Modifier 22 Claims
Question: Must I always file modifier 22 claims manually? Is there an easier and faster [...] - Reader Questions:
Document Ultrasonic FB Localization Necessity
Question: During surgery, the ophthalmologist performed an ultrasound of the patient's eye to locate a [...] - Reader Questions:
Expect More Money From In-Office Procedure
Question: What is the difference between facility and nonfacility relative value units (RVUs)?South Carolina SubscriberAnswer: [...] - Reader Questions:
Aim for Proper Ametropia ICD-9 Code
Question: Which ICD-9 code should I report for ametropia?Kansas SubscriberAnswer: The appropriate diagnosis code for [...] - Reader Questions:
NPI Deadlines Still Loom -- Be Prepared
Question: I'm still confused about what the May 23 deadline is for the NPI changes. [...]
