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Optometry Coding & Billing Alert

Build a Better Business
Streamline your collections system and get money due you faster with these tips on compl... Read more
Look to G, V Codes When Reporting Medicare Glaucoma Screens
ABN is a must if patient is ineligible for covered test When your optometrist performs ... Read more
CPT Update:
Call on Codes for Phone E/Ms in 2008
- but you-ll have to negotiate for payment with private carriers The AMA has released i... Read more
CPT Update:
Include Solid Counseling Notes on Nursing Claims
AMA scraps its old definitions for 99307-99310 You-ll finally be able to use time as th... Read more
'Birthday Rule' Application Vital for Dependent-Child Billing
Be careful: Some states observe -gender rule- instead If your optometrist provides serv... Read more
Billing Question:
Invest in Tamper-Resistant Rx Pads
Question: At a recent conference I attended, someone mentioned a new rule about needing ... Read more
You Be the Expert:
Coding OCB/A-Scan Combos
Question: An established Medicare patient reports to the optometrist for an optical cohe... Read more
Reader Questions:
Yes, You Can Look Up NPI Information
Question: Is the NPI database up yet? I can't figure out where to look for it. Wyoming ... Read more
Reader Questions:
Multiple FBs Might Mean Single Removal Code
Question: How should I report the encounter when the optometrist removes a pair of non-m... Read more
Reader Questions:
Severity of Retinopathy Drives Diagnosis Choice
Question: A patient with nonproliferative diabetic retinopathy reports to the optometris... Read more
Reader Questions:
Work With Surgeon's Office to Ensure Post-Op Pay
Question: We are providing postoperative care to a Medicare patient who recently underwe... Read more
Streamline Your Post-Op Cataract Claims With a Payment-Producing Action Plan
The right ICD-9 code, surgery dates can prevent initial rejection You can get paid for ... Read more
Support 92135 With This Documentation Checklist
To be useful, your I&R will need 7 items Rest assured that your SLGT charges will pas... Read more
You Be the Expert:
Coding Conjunctival/Corneal FBR Scenarios
Question: An established patient complaining of pain and vision trouble in her left eye ... Read more
Use This FAQ to Take the Stress Out of WC Claims
Knowing which state has jurisdiction over the claim is the key to success If the thoug... Read more
Billing Question:
Offer Same-Day-Pay Frame Discount
Question: Can we give discounts on frames to some of our customers but not to others? C... Read more
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Secure POD for Glasses After Cataract Surgery
If your optometry practice treats patients after they have had cataract surgery, you cou... Read more
Build a Better Business
Streamline your collections system and get money due you faster with these tips on compl... Read more
Reader Question:
Observe Different CMS, CPT Consult Criteria
Question: It is my understanding that if a requesting physician asks for an opinion abou... Read more
Reader Question:
Figure Diagnostic Decision Into E/M Level
Question: A new patient reports with blurred vision and a severe headache. During the co... Read more
Reader Question:
Insert 25 for E/M With Plug Procedures
Question: A new patient reports to the optometrist complaining of pain around his left e... Read more
Boost 92135 Pay With These Insider Secrets
Experts answer your top SLGT coding questionsIf you-re using scanning laser glaucoma testi... Read more
You Be the Expert:
Nursing Home Patient--Eye or E/M Code?
Question: I visited a patient who was in a nursing home. Should I use an eye exam code or ... Read more
Billing Question:
Set 1 Fee for Post-Op Refractive Surgery
Question: How should I report a photorefractive keratotomy (PRK) follow-up exam to Medicar... Read more
READER QUESTIONS:
Is Routine Reporting of 92002, V72.0 OK?
Question: Our office has been coding exams (routine exams) as 92002 and V72.0 when we don'... Read more
READER QUESTIONS:
Check 92025 LCD Before Appealing
Question: Blue Cross and Blue Shield of North Carolina (BCBSNC), United Healthcare (UHC) a... Read more
READER QUESTIONS:
Count Prescriptions as Part of E/M
Question: Is there a code I can use for writing a prescription? If so, may I report it in ... Read more
READER QUESTIONS:
Get the Scoop on 92020, 92060 and 92100
Question: Some CPT code descriptions include the phrase -separate procedure.- What does th... Read more
You Be the Expert:
Coding for Keratoconus Contact Lenses
Question: I-m confused about when I should use 92070 versus 92310. Which one should I us... Read more
Reader Question:
Do You Need a Shredder Strong Enough for CDs?
Question: Our medical office is researching document shredders before purchasing one. ... Read more
Reader Question:
PPOs Offer Members Greater Freedom Than HMOs
Question: What are the main differences between a preferred provider organization (PPO) ... Read more
Reader Question:
Probate Status Is Key for Deceased Collections
Question: About a week ago, a patient who owes our practice $10,000 died. Do you have an... Read more
Reader Question:
You Have CMS' OK to Charge No-Shows
Question: I-ve heard that Medicare changed its policy on billing for missed appointmen... Read more
Reader Question:
Find New ABN Forms on the CMS Web Site
Question: I-ve read that there's a new ABN form floating around out there, but I can't f... Read more
Reader Question:
Do Office Billers Need Liability Insurance?
Question: Some of my colleagues have biller/coder insurance. What exactly is biller/code... Read more
Go With EHR to Improve Your Practice's Billing Accuracy, Efficiency
This approach takes guesswork out of system selectionIf you-re not using electronic health... Read more
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Ask the Right EHR Questions
Arm yourself with this handy list when you talk to vendorsMaking sure you get concrete ans... Read more
3 Steps Ensure Proper Punctal Plug Pyament Every Time
Stress the importance of medical necessity in the documentationWhen the optometrist decide... Read more
You Be the Expert:
Eye Exam vs. Consultation Coding
Question: We had a 55-year-old patient with type I diabetes come in presenting with a chie... Read more
READER QUESTIONS:
Report SureSight With Regular CPT Code
Question: Should I use 0065T instead of 92015 for a SureSight vision screening?New Mexico ... Read more
READER QUESTIONS:
Ensure EO Is Actually Extended
Question: I just got a denial on 92226. I think I might be using this code incorrectly. Ca... Read more
READER QUESTIONS:
Handle Insurer Overpayments in 3 Steps
Question: How should I handle overpayments by insurers? How fast do I have to repay? If th... Read more
READER QUESTIONS:
Watch for Searchable NPI Database
Question: There's so much information out there about using NPIs, but I haven't been able ... Read more
READER QUESTIONS:
Erase PHI Before You Click 'Send'
Question: I sometimes e-mail patient records to consultants or other coders for help on ho... Read more
READER QUESTIONS:
4 Steps Can Ease Locum Tenens Headaches
Question: One of the providers in my office is going to be on extended medical leave. The ... Read more
READER QUESTIONS:
Zoom In On Supervision Requirements
Question: If an NP or PA were to perform a diagnostic test, as long as it was within his s... Read more
Discover if You Can Capitalize on the 1-Year NPI Extension
CMS admits defeat, promises progress on NPI sharing Good news: You-ll have an extra year ... Read more
Go With the Flow to Determine Patient Status
Even if the patient has been to your office before, he might be new Proper billing for va... Read more
Translating Acronyms Is Your Key to Deciphering Op Reports
Use these tips to make turning abbreviations into codes much easier Do you know your OP f... Read more
You Be the Expert:
Separate Schirmer's Test Pay
Question: Can I separately report Schirmer's tests and E/M services?Wisconsin SubscriberAn... Read more
Reader Question:
CMS and CPT 'Consult' Criteria Differ
Question: Past Coding Alert articles contain definitions that differ from CPT. An article ... Read more
Reader Question:
Take the Work Out of WC Claims
Question: Our optometrist saw a patient who came in after a work injury affecting his visi... Read more
Reader Question:
Banish Thoughts of Replacing Provider Numbers
Question: Will the NPI numbers we-re required to start using in May simplify our paperwork... Read more
Reader Question:
Don't Fall Into the Level-3 E/M Coding Rut
Question: I think my optometrists frequently perform evaluation and management visits that... Read more
Reader Question:
Make Sure Dress Code Is More 'Business' Than 'Casual'
Question: We do not want to make employees wear uniforms, but we want a dress code that wi... Read more
Reader Question:
Conduct Self-Audits Regularly
Question: Is it important for our office to perform self-audits regularly, or is it OK jus... Read more
Defend Your Patients' PHI With Shredders
Put shredder where it will be used mostIf an identity thief nabs some of a patient's prote... Read more
Focus on LT, RT and TC Modifiers for A-Scans
Watch out for inconsistencies among your carriersA-scans are some of the most common proce... Read more
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Simplify Your Place-of-Service Coding With This List
Fingertip guide to 5 POS codes eliminates confusionChoosing the correct place-of-service (... Read more
You Be the Expert:
Modifiers and Incident-To Services
Question: Should I use a modifier when reporting services provided incident-to the optomet... Read more
READER QUESTIONS:
Don't Count on Cash for Education
Question: Is there a way we can offset the cost of educational materials, pamphlets, etc.,... Read more
READER QUESTIONS:
Satisfy Consult Criteria With a Fax
Question: To use a consultation code, a coworker thinks we should make sure the requesting... Read more
READER QUESTIONS:
Educate Staff Before E-Mailing Patients
Question: Our physician wants the office to begin using e-mail to contact our patients. Ca... Read more
READER QUESTIONS:
Strengthen Your Denial Management Efforts
Question: Are there any tips you can offer on how to handle denials? It seems to take a lo... Read more
READER QUESTIONS:
Keep 'Pharm' Hands Off Patient Info
Question: Our medical office has had problems with -phishing- scams on our Web site. Today... Read more
READER QUESTIONS:
Head Off Copay Problems With Proactive Phone Work
Question: We are in the midst of a copayment crisis. In the past month, we have had four p... Read more
READER QUESTIONS:
If It's Not Relevant to Encounter, Leave Chronic Condition Dx off Claim
Question: A patient with type II diabetes reported to the optometrist for an  exam. T... Read more
News You Can Use:
CMS Extends 1500 Deadline--Don't Miss These Key Details
Find out how a red arrow on the form can make or break your claimsDon't discard your old C... Read more
Safeguard Glaucoma Screening Claims With Expert Answers to Your Top-3 Coding Questions
Determining eligibility comes before you start to think about G0117 and G0118Choosing the ... Read more
Quick Quiz:
How Much Do You Really Know About Using V Codes?
Test your diagnosis coding knowledge with these questionsIf you think V codes are only for... Read more
You Be the Expert:
Coding for VF Interpretations
Question: We did a visual field at the request of a primary-care physician for a patient w... Read more
READER QUESTIONS:
Keep an Eye on Chronic Conditions
Question: The 1997 audit guidelines state that I can reach an extended history by updating... Read more
READER QUESTIONS:
Avoid Automatic Resends
Question: When we know that the carrier has made a mistake in denying a claim, can I just ... Read more
READER QUESTIONS:
Never Use E Codes as Primary Diagnoses
Question: I-ve never really understood E codes and when I should use them. Would you expla... Read more
READER QUESTIONS:
Consider a Financial-Hardship Policy
Question: Is it OK for our practice to not collect a copay or deductible from a patient wh... Read more
READER QUESTIONS:
Give Payers Notice When You're Sending an ABN
Question: When our physicians perform a procedure  that we-re fairly sure Medicare wo... Read more
READER QUESTIONS:
Provide Collection Agencies All the Details
Question: We-ve decided to turn over some of our outstanding accounts to a collection agen... Read more
Make A-Scan Coding As Easy As 1-2-3 With These Expert Tips
Caution: Bilateral modifiers may not be appropriateWhen you see words such as -ultrasound,... Read more
Fight Back Against Consult Denials by Proving 5 R's
Not documenting the request could land you in hot waterYou can probably recite the three -... Read more
Kiss Your Payments Goodbye if You Ignore SNF Patient Status
Not knowing covered services for SNF patients will cost you time and moneyIf you think the... Read more
You Be the Expert:
Are You Required to Report Both Wrongful and Incidental Disclosures?
Question: What is the difference between a wrongful and an incidental disclosure of protec... Read more
READER QUESTIONS:
Educate Staff Before E-Mailing Patients
Question: Our optometrist wants the office to begin using e-mail to contact our patients. ... Read more
READER QUESTIONS:
Move Patient Payment Discussions Away From Front Window
Question: A patient with a $60 past-due balance reports to the office for his annual check... Read more
READER QUESTIONS:
Check Probate Status for Clues on Collecting From Dead Patient's Estate
Question: About a week ago, a patient who owes our practice $2,000 died. Do you have any a... Read more
READER QUESTIONS:
Should Nonparticipating Providers Still Collect Copays?
Question: Do we have any obligation to try to collect copays or deductibles when we are no... Read more
READER QUESTIONS:
Do Office Billers Need Liability Insurance?
Question: I know that some of my colleagues have biller/coder insurance. What I don't know... Read more
Safeguard Glaucoma Screening Claims With Expert Answers to Your Coding Questions
Determining eligibility comes before you even start to think about G0117 and G0118 Choosi... Read more
Boost Productivity, Speed Payment With Practice Management Software
Use this advice to avoid spending a bundle for the wrong system Medical practice manageme... Read more
Focus on Biggest Bills in Self-Pay Backlog
You can't chase every delinquent account, experts say When a self-pay patient is behind o... Read more
YOU BE THE EXPERT ~ Coding for Patient-Generated Second Opinion
Question: I know that CPT deleted the confirmatory consult codes for reporting second opin... Read more
READER QUESTION ~ Conduct Self-Audits Regularly
Question: I heard that if I report mostly 99213s and keep my evaluation and management cod... Read more
READER QUESTION ~ Append Modifier 26 for VF Interpretation
Question: We did a visual field at the request of a primary-care physician for a patient w... Read more
READER QUESTION ~ Conduct Self-Audits Regularly
Question: Is it important for our office to perform self-audits regularly, or is it OK jus... Read more
READER QUESTION ~ Give Collection Agencies All the Details
Question: We-ve decided to turn over some of our outstanding accounts to a collection agen... Read more
READER QUESTION ~ Never Use E Codes as Primary
Question: I-ve never really understood E codes and when I should use them. Would you expla... Read more
READER QUESTION ~ Capture Self-Pays With NEMBs
Question: I keep hearing the term NEMB, but I-m not sure what exactly it is. I know that i... Read more
Pay Close Attention to Place-of-Service Denials
Make sure you don't confuse nursing facilities and skilled nursing facilities Every c... Read more
Know Your Modifiers and Avoid Denials of Diagnostic Services
Use modifier 50 when a code has a bilateral indicator of -1- Keeping straight which diagn... Read more
Get the Lowdown on Best No-Show Policies
Tip: Make sure your carriers don't frown on payment penalties Every office has them ... Read more
NEWS YOU CAN USE ~ Congress Freezes CF, Thwarts Payment Cuts
You should expect stable payments in 2008, too Good news: Congress acted at the very ... Read more
YOU BE THE EXPERT ~ Link First Plaquenil Exam to Underlying Condition
Question: What is the proper way to code a visit to monitor a patient on a high-risk medic... Read more
READER QUESTION ~ Turn to Medicare Web Site for LCD Search
Question: Where can I go to look up Medicare carriers- local coverage determinations? Also... Read more
READER QUESTION ~ Don't Modify Nonconclusive HRT Claim
Question: How should I code for a nonconclusive HRT? One of our patients had one done, but... Read more
READER QUESTION ~ Current Condition Should Drive Your Diagnosis Coding
Question: How should I bill BCBS for a routine exam with the diagnosis being post-keratopl... Read more
READER QUESTION ~ Ask Insurer How to Prove Medical Necessity for Gonioscopy
Question: Which diagnosis codes prove medical necessity for gonioscopy?Ohio Subscriber An... Read more
READER QUESTION ~ Observe Secondary Payment Limits on Medicaid Patients
Question: I have a patient who has Medicare primary and Medicaid secondary. When I submit ... Read more
CPT BASICS ~ Why You Should Dump the Status Quo for Contact Lens Reporting
Find out which service is often underpaid by carriers CPT 2006 altered the contact le... Read more
CPT 2007 UPDATE ~ Make the Most of the Payment Opportunity in Code 92025
Finally, CPT adds a code for corneal topography Optometry coders are reacting with cauti... Read more
Open Your Eyes to Code Evaluation Exams Properly
Determine the difference between intermediate and comprehensive You must know the fou... Read more
YOU BE THE EXPERT ~ Be Cautious With Modifier 25
Question: When a patient with a foreign body or chalazion comes in as a referral from anot... Read more
READER QUESTION ~ Stick to V2521 for Astigmatic Contacts
Question: Which code should we use for monthly replacement toric contacts? We have been us... Read more
READER QUESTION ~ Let the Elements Drive Your History Documentation
Question: The chart that optometrists use to select the level of history includes identifi... Read more
READER QUESTION ~ Report EOM Function Test With E/M
Question: My optometrist wants to code for a -detailed evaluation of EOM function.- The di... Read more
READER QUESTION ~ Diagnosing Irritated Pinguecula
Question: Which diagnosis code should I use for an irritated pinguecula?Connecticut Subscr... Read more
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