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Optometry Coding & Billing Alert

Know the Ins and Outs of Foreign-Body Removal
" Follow our expert advice and translate FBR coding and billing questions into re... Read more
Extend a Warm Welcome to New Consulting Editor
Dr. Wimbish brings practice experience and coding expertise to newsletter Optometry Codin... Read more
Hire and Organize Intelligently To Bill Successfully
Seek a qualified, detail-oriented, small-practice staff that's willing to learn If you're... Read more
Know When Objects Really Are 'Foreign'
Success in billing for punctal plug or rust ring removals lies in your choice of codes Op... Read more
You Be the Expert:
Glaucoma Diagnosis Scan
Question: What's the proper way to bill a GDxscan to Medicare?Missouri SubscriberAnswer: U... Read more
CPT Reminder:
No More Amazing Grace Period To Use New Codes
Starting Jan. 1, you'll have to start reporting the new codes immediately CMS has scrapp... Read more
READER QUESTIONS:
Shun 92310 for Therapeutic Contacts
Question: I'm having trouble getting non-Medicare carriers to reimburse me for therapeutic... Read more
READER QUESTION:
Use Most Specific ICD-9 Code for Visual Fields Claims
Question: We keep getting denials for 92082 and 92083 (Visual field examination ...) linke... Read more
READER QUESTION:
To Find Allowables, Just Ask
Question: How can I find out what an insurance carrier's allowables are for certain proced... Read more
READER QUESTION:
Download Tool to Help Determine Primary Payer
Question: When patients have private insurance in addition to Medicare, is there an easy w... Read more
READER QUESTION:
Resubmit Erroneous Claims for Audit Protection
Question: We've just discovered that we have been using the wrong place-of-service code on... Read more
Choose Wisely Between 92082 and 92083 With This Expert Strategy
"With over $60 on the line, don't risk submitting the wrong code or inadequate documentati... Read more
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Stop 92081-92083 Denials With This Documentation Form
Recording visual fields interpretation and report the right way helps keep the auditors aw... Read more
Figure Out Frequency Rules for Surefire VF Claims
Key: Severity of disease decides how often you can bill 92081-92083 If you're examining a... Read more
2005 RVU Update:
Look Forward to a 23 Percent Boost in A-Scan Fees
Check out this analysis for the lowdown on where you'll gain - and lose The good news: Y... Read more
At a Glance:
Chart the Changes to 2005 RVUs That Will Have the Greatest Impact On Your Bottom Line
Where are the fees for optometrist's services going next year - up or down? Keeping track... Read more
Correction:
Don't Bill for Gonioscopy If You Don't Perform It
An article in the August 2004 Optometry Billing and Coding Alert, "Perfect Your Coding Tec... Read more
You Be the Expert:
Routine Exam for Keratoconus Patient
Question: How should I bill for a routine exam with the diagnosis post-keratoplasty in the... Read more
Reader Questions:
Determine New Patient Status by the 3-Year Rule
Question: Can we report a new patient code if a patient stops seeing one optometrist in ou... Read more
Reader Questions:
Don't Let Common Mistakes Mess Up Your
Question: We receive a ton of denials on paper claims, and I think it's mostly due to the ... Read more
Reader Questions:
Ask Carrier for 76514 Policy
Question: What's the correct procedure code for pachymetry? Which ICD-9 codes are covered?... Read more
Successfully Code Visual Impairment Therapy For Top-Notch Reimbursement
Medicare's policy can make for tricky low-vision coding - but our expert advice will help ... Read more
Make Sure the Patient Qualifies For Rehab Services
Not every Medicare beneficiary can receive low-vision services - here's how to find out wh... Read more
You Be the Expert
Does Old BB-Gun Injury Have Bearing on Coding? Question: We have a patient who came in fo... Read more
Billing Corner:
Who Gets the Bill: Medical or Routine Vision Insurance?
Use the patient's chief complaint and history of present illness to decide When a patient... Read more
Collections Corner:
5 Ways to Wrangle Overdue Patients Diplomatically
Try courtesy before playing hardball to collect payment for servicesA small-practice optom... Read more
Clarification:
Medicare Bundles Scanning Laser and Fundus Photography
An article in the August 2004 Optometry Coding and Billing Alert, "Perfect Your Coding Tec... Read more
Reader Question:
Use New Condition to Determine Eye Code Level
Question: I know that Medicare prefers optometrists to use the 92000 codes rather than the... Read more
Reader Question:
Code 92225 and 92250 Together When Medically Necessary
Question: When is it appropriate to bill for extended ophthalmoscopy and fundus photograph... Read more
Reader Question:
Don't Lose Sleep Over After-Hours Visits
Question: How should I code for a patient who was seen at 10:30 p.m. to collect for the af... Read more
Reader Question:
Use G0117 for High-Risk Medicare Patients
Question: I'm a little confused about HCPCS code G0117. I know that V80.1 (Special screeni... Read more
Reader Question:
Describe Follow-Up Visits Accurately With V Codes
Question: If a patient receives treatment and the condition was resolved, which ICD-9 code... Read more
Think E/M Codes and Eye Codes Are Interchangeable? Think Again
Go for accuracy, not RVUs, when coding office visits - a wrong choice could cost you $170 ... Read more
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Uncover the Best E/M or Eye Code
Keep these definitions handy to help select the right office visit code No more flipping b... Read more
8 Simple Steps Adjust Your Fees For Higher Reimbursement
Are you losing money if a carrier pays dollar for dollar on a claim? If you haven't done a... Read more
Document Supervision Levels Or Face Denials for Diagnostics
 Avoid hot water by showing that a physician was on-site supervising fluorescein angi... Read more
You Be the Expert:
Sniff Out Reimbursement From SNFs
Question: We recently started seeing patients at a skilled nursing facility. Medicare is s... Read more
Quick Key:
Supervision Levels for Ophthalmological Diagnostic Tests
 Keep the levels straight - and elevate your documentation to the next level CMS has ... Read more
Reader Questions:
Medicare Never Passes on Glasses For Cataract Patients
Question: I have a Medicare patient who recently had cataract surgery. We fit her with a p... Read more
Reader Questions:
A World of Difference Between XXX And 000 Globals
Question: What's the difference between an "XXX" global period and a "000" global period?I... Read more
Reader Questions:
Complaint Justifies E/M Code With Modifier -25
Question: A patient presented with a complaint of foreign-body sensation. I found trichias... Read more
Reader Questions:
Look to Fee Schedule Database for Bilateral Guidance
Question: If I place punctal plugs in both of a patient's eyes, should I code it bilateral... Read more
Perfect Your Coding Technique With These Expert Scenarios
5 cases illuminate a day in the life of an optometristIn a single day at the office, you c... Read more
ICD-9 Coding 101:
Nail Your Dx Codes in 4 Easy Steps
The key to getting your diagnosis codes right is knowing the exact condition the optometri... Read more
Carve Out Time to Prioritize for Successful Small Practice Billing
Expert tips show how a biller can 'wear many hats' and make it look goodAs a biller in a s... Read more
Correction:
Noridian Pays 67820 Per Procedure
An article in the July 2004 issue of Optometry Coding & Billing Alert, "Avoid Irr... Read more
No-Shows Are No Fun, but Prevention Is the Key
Reminder calls, no-show fees and good documentation can helpPatients who don't show up for... Read more
You Be the Expert:
No Dilation? Can You Still Bill the Exam?
Question: Can we bill for a comprehensive eye exam with 92004/92014 if the optometrist did... Read more
HIPAA Q&A Session:
Does Your Practice Protect PHI Like It Should?
What many practices don't realize is that HIPAA violations can occur in the simplest funct... Read more
READER QUESTIONS:
Check for the Three R's of a Consultation
Question: A local gastrointestinal specialist called and wanted our optometrist to check o... Read more
READER QUESTIONS:
List 368.8 as a Secondary Diagnosis, if Possible
Question: Many of our patients claim general reasons for their visit, such as "I can't see... Read more
READER QUESTIONS:
With Collections, It Pays More to Be Nice
Question: Our practice is having trouble collecting on our past-due accounts. We follow a ... Read more
Avoid Irritation While Coding Epilation for Trichiasis
Confusion about coding eyelash removal can be a thing of the past if you can keep up with ... Read more
Quick Key:
Lash Out With These ICD-9 Codes
Regardless of how you code epilation, you must document an ICD-9 code that signals to Medi... Read more
NCCI 10.2 Update:
CMS Increases Retrobulbar Injection Bundles
67500 is now bundled into all but 16 eye codes The latest National Correct Coding Initiati... Read more
HIPAA Corner:
Passwords Secure PHI for Your Eye Patients
5 steps to keep hackers guessing Protected health information (PHI) should be a primary co... Read more
You Be the Expert:
Follow-Up Exams After FB Removal
Question: One of our optometrists uses a slit-lamp to check on healing after a foreign-bo... Read more
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Make Your Case for Separate Services
Use this sample letter to help appeal modifier -25 denials A patient presents with eye pai... Read more
Reader Question:
Use V Codes for Plaquenil Patients
Question: Which diagnosis code should I use to report visual field tests to evaluate the ... Read more
Reader Question:
Don't Echo Echography Code
Question: I'm trying to submit a claim for 76514 performed on both eyes, but I've been ge... Read more
Reader Question:
Billing Refractions Without Prescriptions
Question: Is it appropriate to bill a patient for 92015 even if the optometrist doesn't g... Read more
Reader Question:
Doctors Can Refer Family, Can't Bill for Treatment
Question: I am not sure how to bill for this situation: Doctor A refers his father to Doc... Read more
Reader Question:
Don't Write Off No-Shows Yet
Question: Can our office bill for no-show appointments? What are our legal rights as far ... Read more
Reader Question:
Stick to V Codes for Screenings
Question: If an eligible patient presents for a glaucoma screening, and testing reveals i... Read more
Not Getting Paid for Contact Prescriptions? You Will After You Read This
92310 won't cut it - but this strategy for keratoconus and aphakia patients will You know ... Read more
Billing Basics:
Time Is Money
Get paid what you deserve by billing for the time component of E/M visits Fact: You can bi... Read more
Coding Corner:
Reduce Denials With More Definitive Diagnosis Coding
Use these 5 strategies to boost your reimbursement Important: Don't jump the gun on billin... Read more
News You Can Use:
Say Goodbye to Your Coding Grace Periods, Thank HIPAA
Tip: Review the CMS Web site to update charge forms sooner rather than later CMS has scrap... Read more
You Be the Expert:
Get Paid for Low-Risk Glaucoma Screenings
Question: Our office sometimes performs glaucoma screenings for patients who don't meet Me... Read more
Reader Question:
Use Proof of Filing to Get Your Claim Paid
Question: I have been trying to get a claim through to one of our carriers for more than a... Read more
Reader Question Spotlight:
This Texas subscriber submitted a question no optometry practice can afford to miss ...
Split the Bill Correctly With -55 Question: Many local ophthalmologists rely on our optome... Read more
Reader Question:
Work Through Workers' Comp Questions
Question: Should I code any differently for workers' comp claims? What if more than one st... Read more
Don't Be Vague When Coding Nonspecific Complaints
Knowing the right codes to report for blurry vision can save your practice from costly den... Read more
Billing Basics:
5 Q&As Explain Workers' Comp
A fee schedule can help you recoup an extra 15 percent The guidance and fee schedules you... Read more
You Be the Expert:
Weigh Pros and Cons of VF Codes
Question: We have a patient who is "glaucoma suspect." He is returning to our office for a... Read more
SPECIAL REPORT:
Collections Strategies - You can save time and money while preventing headaches
Outsource Collections for Better ResultsGenerate revenue from past-due accounts by hiring ... Read more
SPECIAL REPORT:
Collections Strategies - You can save time and money while preventing headaches
Collections Countdown6 steps to take before sending accounts to the collector When should... Read more
SPECIAL REPORT:
Collections Strategies - You can save time and money while preventing headaches
Collections Tip: Get your money by calming patient fears Patients who don't respond to you... Read more
Reader Question:
Sort Out Referrals and Consults
Question: Can an optometrist bill for a written report to the patient's physician who orig... Read more
Reader Question:
Don't Push Limits on E/Ms and -25
Question: Let's say I have a patient with eye pain (379.91), and I find a lash that is irr... Read more
Reader Question:
Safeguard Your Office Funds With This Checklist
Question: Do you have any recommendations for how we can protect our office against embezz... Read more
Reader Question - Liability Insurance:
It's Worth Asking About
Question: I've heard a lot of talk recently about biller and coder liability insurance. Wh... Read more
Coding Corner:
Test Yourself: Would You Append Modifier -25?
These 3 common optometry scenarios clear up when you can -- and can't -- separately report... Read more
Billing Basics:
Fight Underpayments With This Simple 4-Step Trick
There's something you can do about these annoyances -- today!You can win: Beat carrier und... Read more
Cover All Your Documentation Bases for a Reimbursement Home Run
Before you use modifier -25 to file for reimbursement for an E/M and plug insertion, make ... Read more
Hipaa Help Desk:
File Complaints Using New Online Tool
You now have some recourse if a software vendor, clearinghouse or payer is getting in the ... Read more
You Be The Expert:
Don't Fake It for Pseudo-Strabismus
Question: We had a patient present with crossing of the eyes, but when the optometrist p... Read more
Coding Corner:
Ease Into Using E Codes
You can never supply too much information when submitting a claimThe next time a patient p... Read more
News You Can Use:
Medicare Nearly Doubles A-Scan Pay
CMS' Fee Schedule update increases reimbursement for several ophthalmic proceduresIf Medic... Read more
Reader Question:
Tackle Tough Medicare Payment Problems
Question: Medicare has been denying some of our claims, and I think it is mistaken. What s... Read more
Reader Question:
Unfurrow Your Brow With 701.8
Question: Which diagnosis code should I report for brow ptosis?Ohio Subscriber Answer: Use... Read more
Reader Question:
Protect International PHI
Question: Does the HIPAA regulation apply to information gained abroad that is used or sto... Read more
Reader Question:
Manners Matter to Payers
Question: We had a run-in with one of our carriers, and ever since then they have been rea... Read more
Coding Corner:
Avoid Denials by Linking These ICD-9 Codes to Ophthalmoscopies
Use 362.81 to get paid for 92225If you are linking ophthalmoscopy procedures to a diagnosi... Read more
Billing Basics:
Plug Up 68761 Reimbursement With This Expert Strategy
Hint: Modifier -50 won't get all 2-plug claims paid Modifiers pose the greatest difficulty... Read more
HIPAA Help Desk:
Keep Tabs on Floppies and CDs Containing Patient Info
Follow these 6 tips to remain HIPAA-compliantIf you leave the office with portable media s... Read more
You Be The Expert:
Take Pressure Off Glaucoma Dx Coding
Question: We had a patient present with high intraocular pressure, a symptom of glaucoma, ... Read more
Reader Question:
Fix Faxing for HIPAA Compliance
Question: I accidentally reversed two digits of a fax number and faxed medical information... Read more
Reader Question:
Don't Take the Money and Run
Question: How should I handle overpayments by insurers? How fast do I have to repay? If th... Read more
Reader Question:
Catch More Copays With These Billing Tips
Question: One of the most unpleasant chores in our office is collecting copays. We have th... Read more
Reader Question:
Don't Get Mad, Get Reimbursed
Question: One of our private carriers is denying 92250 when performed on the same day as f... Read more
Reader Question:
Get Tough on Bounced Checks
Question: Every once in a while, a patient's check bounces. We not only lose the patient's... Read more
Reader Question:
Fight for After-Hours Reimbursement
Question: I saw a patient at 5 a.m. on a holiday for a corneal ulcer. We billed an office ... Read more
Reader Question:
Clear Up Cataract Coding
Question: A Medicare patient presented with a cataract in his right eye. Our optometrist p... Read more
Coding Corner:
Master Modifiers -26 and -TC for New Corneal Pachymetry Code
Avert confusion over new 2004 codes with this update CPT 2004 has replaced Category III co... Read more
Billing Update:
New Conversion Factor Announced
Optometrists break even as work RVUs are cut, conversion factor increases Thanks to the M... Read more
HIPAA Training Tips:
What Your Staff Must Know About Privacy Complaints
4 ways to prepare your front line The receptionists at your practice's front desk may be y... Read more
Compliance Help Desk:
Be Sure the Feds Know You're Not One of the Bad Guys
Coders and optometrists who want to avoid fraud or other criminal charges would be wise to... Read more
You Be the Expert:
Plan on Keeping Medical Records Long-Term
Question: How long should I keep old medical records?Florida SubscriberAnswer: It depends ... Read more
HIPAA Compliance Quiz:
Do You Hear What I Hear?
Can you and your staff spot the difference between a permitted incidental disclosure and a... Read more
Reader Question:
One-Two Punch for Ophthalmoscopy Coding
Question: How should I bill for an extended ophthalmoscopy (92225-92226)? Is one code for ... Read more
Reader Question:
Plug In for Better Documentation
Question: I've heard that electronic medical records can help cut denials. Is that true?&n... Read more
Reader Question:
Shred - but Don't Cut Corners
Question: How should our medical practice dispose of hard copies of files?  &nbs... Read more
Reader Question:
Know the ABCs of ABNs
Question: Am I allowed to change Medicare's advance beneficiary notice (ABN) form to bette... Read more
Reader Question:
DRS Dilemma?
Question: If the patient asks for a copy of her medical records, are the records from othe... Read more
Coding Corner:
Avoid Fraud Charges and Ensure Payment for 'High-Risk Patients
Medical necessity is a must for optimal payment Make sure you know the definition of ... Read more
Compliance Help Desk:
Detect HIPAA Violations
Stop problems before the Office for Civil Rights stops you You've spent months developing ... Read more
You Be the Expert:
Appeal 'Untimely Filing'
Question: I sent a claim to the insurance company and have proof that the claim was sent, ... Read more
Billing Basics:
When Payers Back Out, Handle Patients With Care
Let them know you're on their side No one likes to inform patients when payers back o... Read more
Coding Corner:
CPT Clears Up Cloudy Starred Procedures
Don't let deleted 'stars' disrupt your private-carrier reimbursement The ... Read more
Regulatory Update:
Payments Increase 1.5% for Physicians in 2004, 2005
 Slated 4.5% cut averted by new Medicare bill Higher reimbursements for the new year?... Read more
Reader Question:
One-Two Punch
Question: How should I bill for an extended ophthalmoscopy (92225-92226)? Is one code for ... Read more
Reader Question:
A Marriage of Convenience?
Question: How does HIPAA affect married couples? Does HIPAA allow for more disclosure to a... Read more
Reader Question:
A Map for Reporting Topography
Question: How should we correctly bill topography? We used 92499 (Unlisted ophthalmologica... Read more
Reader Question:
Higher Than HIPAA
Question: Does HIPAA specify how records dealing with chemical or alcohol dependency have ... Read more
Available Years:  2004  2003