Ophthalmology and Optometry Coding Alert
Break Down Descriptions to Uncover Transposition Code
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer. Question: A patient presented with severe nerve palsy. My ophthalmologist's operative notes report cutting of the superior oblique tendon at the medial border of the superior rectus muscle and 2 mm anterior to the medial insertion of the superior rectus muscle. He also reported recessing the lateral rectus muscle. How should I code all of this? OPC Subscriber Determine which muscles were operated on and what was done to them.
Answer: To ensure accurate coding, break down each service description into "codeable" language.
The first piece of information to note is the "cutting of the superior oblique tendon." This wording may throw you off if you don't know that the superior oblique muscle is also known as the superior oblique tendon. This is the muscle that wraps around the eyeball, and its recession or resection is described by 67318 (Strabismus surgery, any procedure, superior oblique muscle).
The second important piece of information is the recession of the lateral rectus muscle, a horizontal muscle, which can be coded 67311 (Strabismus surgery, recession or resection procedure; one horizontal muscle). You must append modifier -51 (Multiple procedures) to 67311 to indicate that more than one procedure was performed on the same site.
Ophthalmology and Optometry Coding Alert
- CPT 2003:
Finally, a New Endoscope Code
The CPT Editorial Panel has answered ophthalmology coders' call for a code to describe diagnostic [...] - Distinguish Eye Codes From E/M Codes
Ophthalmology coders have the luxury of having two sets of codes to represent office visits [...] - FAQs About Eye Codes
The extensive guidelines explaining how to properly use the general ophthalmological service codes, commonly known [...] - Please Payers With Proper Low-Vision Therapy Coding
CMS' recent reiteration of the 2000 decision to cover rehabilitation services for Medicare beneficiaries with [...] - News Brief:
CMS Issues 2003 IOL Implant Reasonable-Charge Instructions
Payments under local carrier jurisdiction for intraocular lenses implanted in a physician's office are subject [...] - Reader Question:
Diagnosis-Code SBS From Documentation
Question: Our pediatric ophthalmologist was recently called to the ER to consult on a potential [...] - Reader Question:
OPT Patients With Signed ABNs Require -GA
Question: Should I use modifier -GA when my ophthalmologist is performing ocular photodynamic therapy (OPT) [...] - Reader Question:
Report Modality for Multiple Retina Repairs
Question: Our ophthalmologist repaired a detached retina in the left eye. He used both cryotherapy [...] - You Be the Coder:
Modify Multiple Glaucoma Surgery Coding
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Iron Out Wrinkles in Your Botox-for-Strabismus Coding
The increased use of purified botulinum toxin trade name Botox in ophthlamological procedures is causing [...] - Boldly Bill Botox Supplies
With one vial of botulinum toxin costing more than $350 per 100 units and lasting [...] - Translate Muscular Language Into Strabismus Surgery Codes
Translating the ophthalmologist's documentation into procedure codes is often the hardest part of coding strabismus [...] - Reader Question:
Demonstrate Necessity for Adult-Strabismus Payment
Question: Can we get paid for adult-strabismus surgery or is this always considered cosmetic? Nebraska [...] - Reader Question:
Dont Use False Diagnosis Codes for Pseudo-Strabismus
Question: Am I just overlooking the pseudo-strabismus diagnosis code or is there not one? We [...] - Reader Question:
Check Carrier Policy Before Coding MRIs for Strabismus
Question: When is an MRI covered if the diagnosis is strabismus? Kentucky Subscriber Answer: Great [...] - Reader Question:
Bravely Bill -50 With Bilateral Add-On Codes
Question: If I am coding for strabismus surgery for a patient who had scarring in [...] - Reader Question:
Find the Lost Muscle Code
Question: My ophthalmologist noted a "slipped muscle" in his strabismus surgery documentation. What does this [...] - Reader Question:
Be Careful Billing Botox and Office Visits
Question: A patient was in the office for Botox injections for strabismus. Can we also [...] - You Be the Coder:
Break Down Descriptions to Uncover Transposition Code
Test your coding knowledge. Determine how you would code this situation before looking at the [...]
