Ophthalmology and Optometry Coding Alert
Long-Standing Strabismus
Question: Another ophthalmologist referred a new patient with long-standing strabismus to us. How should I code this visit?
Colorado subscriber
Answer: The answer depends upon why the referring ophthalmologist sent the patient to your physician.
1) Was this a request for second opinion with recommendations for care?
2) Or was this referral due to a general ophthalmologist asking a second ophthalmologist who specializes in strabismus-related surgery to take over management of the patient's problem?
A consultation code (99241-99245) may be billed if the referral was for scenario #1 above. However, if scenario #2 is more accurate, then bill the office visit with code 99201-99205 for a new patient or 99211-99215 for an established patient.
If you also perform a sensorimotor exam, be sure to report it separately with 92060 (Sensorimotor examination with multiple measurements of ocular deviation with interpretation and report [separate procedure]). If you use this code, you are also required to complete a separate interpretation and report.
Watch out: A sensorimotor exam is considered bundled with code 99211 and should not be separately billed.
Ophthalmology and Optometry Coding Alert
- CCI 18.0 Update:
67961-67966 Includes Graft Site Preparation
Also: Watch for these new eyelid reconstruction Correct Coding Initiative edits. If your ophthalmic surgeon [...] - Part B Update:
Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012
Plus: Claims reprocessing has completed, so make sure your claims have been corrected. As many [...] - Fee Schedule Update:
Expect 2-Month Medicare Payment Reprieve
SGR formula fix is key.You won't face a 27 percent Medicare pay cut beginning Jan. [...] - Workers' Compensation:
5 Guidelines Ease the Pain of Billing Workers' Compensation
If you don't get pertinent information before seeing the patient, expect trouble when you start [...] - You Be the Coder:
Long-Standing Strabismus
Question: Another ophthalmologist referred a new patient with long-standing strabismus to us. How should I [...] - Reader Question:
367.9 Is Best Choice for Ametropia
Question: Which ICD-9 code should I report for ametropia? Kansas Subscriber Answer: The appropriate diagnosis [...] - Reader Question:
Collect Surgical Deductibles Up Front
Question: We often have patients who don't pay their deductible after surgery. Is there a [...]
