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Optometry Coding & Billing Alert
Optometry Coding & Billing Alert
Optometry Coding & Billing Alert - 2009; Volume 7, Number 12
Prevent Uni-Bi Reporting Errors With This Expert Insight
Prevent Uni-Bi Reporting Errors With This Expert Insight Don't let tricky prefixes stand i...
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2 Expert Tips Ensure Your Share of the Cataract Co-Management Pie
Hint: Call surgeon's office to compare notes after the patient's first visit. ...
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Play by Transfer of Care Rules or Run Afoul of the OIG
It pays to make sure transfers of care are by the book -- the Office of the Inspect...
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E/M Corner:
Hail to the Chief Complaint and Avoid Audit Trouble
CC need not be at the very top of the note, but the OD must state it clearly. Getting din...
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You Be the Expert:
Billing Refractions Without Prescriptions
Question: Is it appropriate to bill a patient for 92015 even if we don't give him a new p...
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Reader Question:
Secure POD for Glasses After Cataract Surgery
Question: Our office often provides eyeglasses to patients after cataract surgery. We've ...
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Reader Question:
Ensure EO Is Actually Extended
Question: I just got a denial on 92226. I think I might be using this code incorrectly. C...
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Reader Question:
Check Medical Necessity Rules for 92025
Question: What are the rules for coding corneal topography? I can't find a CPT code for i...
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Reader Question:
Weigh Eye Exam vs. Consultation Coding
Question: We had a 55-year-old patient with type 1 diabetes come in presenting with a chi...
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Reader Question:
Don't Downcode E/M Service Modifier
Question: Another physician asked my optometrist to provide a consultation on a patient. ...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 11
News You Can Use:
Fee Schedule Cuts Medicare Pay By 21.2%, Scraps Consults
Bonus: Optometry practices may see a 12% raise in RVUs over 4 years. Optometry coders, ge...
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2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new eprescribing numerator code. CMS's 2010 Physician Fee Schedul...
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Prepare for $17 Drop in Eye Exam Payments in 2010
You'll also see $14 less for some established patient E/Ms. A quick glance at the propose...
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Red Flags Update:
Enjoy a Last-Minute Red Flag Reprieve
You now have until June 1, 2010, to comply with FTC rules. Right on the heels of earlier ...
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Build a Better Business:
Seek Outside Help for Lingering Payer, Claims Issues
Problem payer won't communicate? Lean on your colleagues for support. What if you take th...
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You Be the Expert:
Unwrinkle Nursing Facility POS Codes
Question: Our optometrists sometimes go to see patients in nursing homes. What criteria s...
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Reader Question:
Don't Code Fundus Photos Bilaterally for Medicare
Question: Our new software program instructs us to append modifier 50 to code 92250, but ...
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Reader Question:
Who Do You Bill When You're a Non-Par Provider?
Question: I have found it impossible to find out the allowable when your provider does no...
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Reader Question:
Try V45.89 for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our optometrists ...
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Reader Question:
Decide on Electronic vs. Paper Record Retention
Question: My practice is running out of space for storing our paper records. How long do ...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 10
Ace Your A-Scan Reporting With Accurate LT, RT, and TC Modifier Use
Watch out for inconsistencies among your carriers. A-scans are some of the most common pr...
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Build a Better Business:
Step Up Your Collections Efforts With Credit Card Acceptance
Caveat: Protect your patients' credit information to comply with privacy, identity theft ...
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You Be the Expert:
Code Misdirected Eyelashes in the Right Direction
Question: What are the correct modifiers for 67820? Pennsylvania Subscriber Answer: Code ...
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Billing Strategies:
Use Annual Payer Fee Analysis as a Profit Tool
Question: Our practice manager heard at a conference that we should be reviewing our indi...
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Payer Updates:
Check Your Payers Against the AMA's 2009 Report Cards
See which payers rank highest in 6 billing categories. Are you curious about where your t...
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Reader Question:
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later ...
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Reader Question:
Bill Higher Punctal Procedure First
Question: A patient pays a visit to the clinic for a routine eye exam in the morning. CPT...
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Reader Question:
Use Modifier 25 for Same Day, Different Procedure Visits
Question: A patient pays a visit to the clinic for a routine eye exam in the morning. CPT...
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Reader Question:
Specify Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requir...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 9
Ensure That Eye Exams Are Coded at the Right Level by Following These Do's and Don'ts
Discovering common coding and billing errors is the first step to correcting them. Overco...
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PQRI:
CMS Offers Alternative Way to Access Your PQRI Reports
No need to register in the IACS system -- do this instead, officials say. If the IAC...
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You Be the Expert:
VF Defect Due to Pituitary Adenoma
Question: How would you code a visual field defect arising from pituitary adenoma? Florid...
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News You Can Use:
CMS Can't Recoup Overpayments During Appeal
Collect interest if you triumph during third appeal level or thereafter. When CMS sends a...
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Build a Better Business:
Your Warm and Fuzzy Payment Plans May Catch More Money
Save money and patient relations by steering clear of aggressive tactics. Streamline your...
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Reader Question:
Don't Include Refraction Services in Exams
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscriber An...
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Reader Question:
Require Patients to Shell Out for Special Frames
Question: I have a patient who wants to purchase a frame for $200. Medicare allows $74.06...
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Reader Question:
Take Cue for Patient History From ROS Level
Question: What are the four levels of review of systems (ROS) for E/M codes? Wyoming Subs...
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Reader Question:
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf...
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Reader Question:
Does Timely Filing Miss Always Mean No Pay?
Question: A payer denied our claim because we missed the timely filing deadline. The prob...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 8
Prove Medical Necessity for Pre-Bleph Visual Fields or Risk Nonpayment
Frustrated by denials for 'taped and untaped' VFs? Here's how to get the reimbursement yo...
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Clip and Save:
Stop 92081-92083 Denials With This Documentation Form
Record visual fields interpretation and report the right way. Visual fields are a complia...
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Build a Better Business:
Master the Art of Working With -- or Around -- Problem Payers
Follow this 3-step path and get results from every payer. Streamline your collections sys...
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You Be the Expert:
A-Scan With Exam on Second Eye
Question: After we had done an A-scan on a patient prior to cataract surgery on his left ...
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READER QUESTIONS:
These Dxs May Extend 76514 1x Limit
Question: How often in a year can a patient have pachymetry done? Is this a once only in ...
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READER QUESTIONS:
Don't Waste Time Billing $0 Charges
Question: I bill post-op visits with 99024 and charge $0. Sometimes it goes through, but ...
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READER QUESTIONS:
Learn the Fee Schedule Column Differences
Question: I hear all the time that I should be looking at the Medicare Physician fee sche...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 7
Case Study:
Unlock New Billing Opportunities With Silicone Hydrogel Lenses
Know the right CPT and ICD-9 codes for specific conditions - and give your practice ...
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E/M Corner:
Hail to the Chief Complaint and Avoid Audit Trouble
CC need not be at the very top of the note, but the OD must state it clearly. Getting din...
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News You Can Use:
CMS Proposes Scrapping Consult Code Payment
Plus: 21.5 percent cut looms for your services. Heavy pay cuts for your physician's servi...
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You Be the Expert:
Let Slit Lamp Use Determine FBR Code
Question: An optometrist removes a foreign body in a patient's cornea with the help of a ...
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Build a Better Business:
Improve Appeals Success With Loophole-Free Documentation
Get the ball rolling on your claims with this bulletproof checklist. Even when you think ...
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Report EOM Function Test With E/M
Question: The optometrist wants to code for a "detailed evaluation of EOM function." The ...
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Reader Question:
Deconstruct Code 92014
Question: Can you help me break down the guidelines for 92014? How many exam elements mus...
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Reader Question:
Unpack Fundus Photos From Exam Bundle
Question: Is fundus photography bundled with an office visit or consultation? California ...
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Reader Question:
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? New Jersey Subscribe...
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Reader Question:
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fundus photogra...
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Reader Question:
Geography Affects Your Payments
Question: My optometrist has asked me to explain how to figure out what our reimbursement...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 6
2 Tips Lead to Proper Glaucoma Visit Coding
Let form and severity drive your coding choice. Often, optometrists find themselves in a b...
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News You Can Use:
Breathe Easier Thanks to the Red Flags Rule Delay
You'll have more time to get your optometry practice in shape. If you're still trying to ...
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E/M Corner:
ID All HPI Elements for Most Accurate E/M Coding
CPT, CMS don't see eye-to-eye on duration. Not accurately counting history of present ill...
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Correction:
Correction:
An article in Vol. 7, No. 3 of the Optometry Coding & Billing Alert, "Prevent Uni-Bi R...
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Better Collections Rates Start With Better Collections Skills
Well-trained billers may be your biggest assets toward improved collections. With the dec...
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You Be the Expert:
Primary Diagnosis for 'Foggy Vision'
Question: Many of our patients claim general reasons for their visit, such as "I can't se...
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READER QUESTIONS:
Let Disease Damage, Control Drive VF Coding
Question: How often will Medicare allow visual field testing (92081-92083) on a patient? ...
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READER QUESTIONS:
Don't Just Cover Up Paper Claim Errors Question: When we make a mistake on a paper form,
Question: When we make a mistake on a paper form, can we just cross out the wrong informa...
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READER QUESTIONS:
Use Caution With FB Removal and E/M
Question: A patient with eye pain presented to our office. This is a Medicare patient our...
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READER QUESTIONS:
Turn Over Records Even if Patient Owes You
Question: We have a patient with a large balance. She recently called our office and aske...
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READER QUESTIONS:
Can Assistant Perform Laser Scan?
Question: What level of supervision is required for an ophthalmic assistant conducting a ...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 5
2 Expert Tips Ensure Your Share of the Cataract Co-Management Pie
Hint: Call the surgeons office to compare notes after the patients first visit. When m...
Read more
You Be the Expert :
Foreign Bodies in Cornea and Conjunctiva
Question: A patient had foreign bodies in her left eye in both the cornea and ...
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ICD-10 Update:
Get Ready to Report Dx Codes on New HIPAA 5010 Form
You cant submit ICD-10 codes without this new form, starting in 2012. ...
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Play by Transfer of Care Rules
It pays to make sure transfers of care are by the book -- the Office of the I...
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Part 2:
Perfect Your Non-Par Collections With These Options
Prevent hundreds from running out the door with these expert tips. ...
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Correction:
Correction:
A Reader Question in Optometry Coding & Billing Alert Vol. 12, No. 2 (Weigh Eye ...
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READER QUESTIONS :
Medicare Wants 1-Line Entry for Mod 50
Question: I need some information on billing bilateral procedures. For Medicar...
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READER QUESTIONS :
Follow Up to Recoup Missed Payments
Question: Ive landed a job with a practice where no one seems to follow up on ...
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READER QUESTIONS :
Specify Tech vs. Physician With Lens Codes
Question: My optometrist sees routine patients for services such as contact le...
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READER QUESTIONS :
Office Visit OK With Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision trainin...
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READER QUESTIONS :
Bill Most Appropriate Code, Regardless of Payment
Question: We keep getting denials on certain codes from certain payers. The op...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 4
Clear Up Diabetic Coding Confusion with These 3 Expert Tips
Hint: Make sure your specific diabetic Dx matches that of the patients primary...
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Compliance News:
Think Red Flags Rule Doesn't Affect You? Think Again
Get to know new identity theft rules that many optometry practices overlook. ...
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You Be the Expert:
Billing Refractions Without Prescriptions
Question: Is it appropriate to bill a patient for 92015 even if we dont give h...
Read more
HIPAA vs. Red Flag:
What's the Difference?
HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) privacy...
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Clip and Save:
Set Up Your Red Flags Plan With These 6 Tips
Ensure your practice is ready by May 1 with a top-notch plan. Youve...
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BUILD A BETTER BUSINESS:
Perfect Your Non-Par Collections With These Options
Prevent hundreds from running out the door with these expert tips. ...
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READER QUESTIONS:
E/M With 68761? Check Documentation First
Question: When I do a comprehensive exam (92004) and decide to insert punctal ...
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READER QUESTIONS:
Ensure EO Is Actually Extended
Question: I just got a denial on 92226. I think I might be using this code inc...
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READER QUESTIONS:
Conduct Self-Audits at Least Annually
Question: Is it important for our office to perform self-audits regularly, or ...
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Optometry Coding & Billing Alert - 2009; Volume 7, Number 3
Prevent Uni-Bi Reporting Errors With This Expert Insight
Know when to use RT/LT and when to rely on modifier 50. Dont let tr...
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PQRI:
Make Sure These Errors Don't Cause Your PQRI Bonus to Tank
CMS shows which issues sidelined these practices. Most optometry pr...
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You Be the Expert:
Diagnosis Coding for Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim...
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News You Can Use:
Get the Facts on CMS's 30-Day Retro Billing Rule
You wont forfeit quite as much money as previously expected. While ...
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BUILD A BETTER BUSINESS:
Don't Be Left Empty-Handed -- Bill the Patient
You dont necessarily have to forgo payment due to denial. Streamlin...
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READER QUESTIONS:
Check Medical Necessity Rules for 92025
Question: What are the rules for coding corneal topography? I cant find a CPT ...
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READER QUESTIONS:
Can You Code E/M for New-Patient FBR?
Question: A new patient came in today complaining of a foreign body sensation ...
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READER QUESTIONS:
Describe Follow-Up Visits Accurately With V Codes
Question: If a patient receives treatment and the condition was resolved, whic...
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READER QUESTIONS:
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule fo...
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READER QUESTIONS:
Enter the Paper vs. Electronic Claims Debate
Question: Does Medicare accept paper claims anymore? Ive heard that all claims...
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Optometry Coding & Billing Alert - 2009; Volume 7, number 2
PQRI Update:
Share in Bonus Payment With 3 New Ophthalmic Measures
When you don't meet the measure, P modifier ensures compliance. Optometrists who want to ...
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You Be the Expert:
Look to Signs and Symptoms for Normal VF
Question: We had a patient present with high intraocular pressure, a sign of glaucoma, an...
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Clip and Save:
Keep These 2009 PQRI Eye Care Measures Handy
...
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Fee Schedule Update:
Location Will Define Fee Schedule's Effect
Alaska wins big, but Calif. practices see declines. If you take the 2009 Medicare Physi...
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News You Can Use:
Say Goodbye to the 2+ Year Credentialing Period
CMS institutes a 30-day billing window for 2009. New optometrists just lost 26 months of ...
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Build a Better Business:
Save Hundreds With These A/R Best Practices
Tip: Assign each biller a list of payers to contact each month. Streamline your collectio...
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Reader Questions:
Hope for OCT Coverage for Plaquenil Exam
Question: What diagnosis code should we use for OCT when the patient is currently on Plaq...
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Reader Questions:
Check Secondary Payer Copay Rules
Question: A patient's primary insurance had a $15 copay, which we collected from the pati...
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Reader Questions; Secure POD for Glasses After Cataract Surgery
Question: Our office often provides eyeglasses to patients after cataract surgery. We've ...
Read more
Reader Questions:
Weigh Eye Exam vs. Consultation Coding
Question: We had a 55-year-old patient with type 1 diabetes come in presenting with a chi...
Read more
Reader Questions:
Don't Downcode E/M Service Modifier
Question: Another physician asked my optometrist to provide a consultation on a patient. ...
Read more
Optometry Coding & Billing Alert - 2009; Volume 7, Number 1
Play by Medicare Rules to Ensure Your Fair Share of Routine Exam Reimbursement
Help patients understand: Explain that no complaint equals no coverage.Often, ODs don't gr...
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You Be the Expert:
Glaucoma Follow-Up Visit
Question: How should I code an office visit for a wheelchair-bound nursing home patient wh...
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Prepare to See $10 Less for A- and B-Scans
Not all bad news: Payment for eye exams and E/Ms should rise -- slightly.If your prac...
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Build a Better Business:
Don't Let Refunds to Payers Break Your Bank
Hint: Find out exactly where the money should go before you send it.Streamline your ...
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Corneal Pachymetry Payments Stay Solid
Calculate Fees Differently in 2009Here's how the BNA adjustment and the new conver-sion fa...
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Reader Questions:
Make Up Difference for Progressive Lenses
Question: I'm a little confused about coding for optical supplies. One of our patients got...
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Reader Questions:
Code EO to Evaluate Flashers and Floaters
Question: If a patient reports flashes and floaters and we do not find evidence of retinal...
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Reader Questions:
Clear Up Filing Deadline Issues With Chart
Question: Our practice keeps getting denials because we are missing timely filing deadline...
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Available Years:
2009
2008
2007
2006
2005
2004
2003