Ophthalmology and Optometry Coding Alert

$1500 may be at stake for your practice if you report 67210 or 67228 incorrectly. In recent years, more than 4 million people over the age of 40 had diabetic retinopathy -- and of those, 655,500 had DR severe enough to threaten their vision. This is enough to keep ophthalmologists busy with focal laser and photocoagulation treatments, which means that coders should keep busy knowing the coding rules for diabetic retinopathy treatments. Report Edema Diagnosis for Background DR DR patients are usually facing a series of laser treatments, with either a focal laser (67210, Destruction of localized lesion of retina [e.g., macular edema, tumors], 1 or more sessions; photocoagulation) or panretinal photocoagulation (PRP) (67228, Treatment of extensive or progressive retinopathy, 1 or more sessions; [e.g., diabetic retinopathy], photocoagulation). Sometimes, however, ophthalmologists need to use both. To navigate the DR maze, you first have to determine the kind of DR the patient [...]