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Optometry Coding & Billing Alert

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... Read more
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. ... Read more
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... Read more
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... Read more
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... Read more
Reader Question:
Secure POD for Glasses After Cataract Surgery
Question: Our office often provides eyeglasses to patients after cataract surgery. We've ... Read more
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... Read more
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... Read more
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... Read more
Reader Question:
Don't Downcode E/M Service Modifier
Question: Another physician asked my optometrist to provide a consultation on a patient. ... Read more
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... Read more
2010 Final Rule Simplifies E-Prescribing Process
Extra: CMS will debut a new eprescribing numerator code. CMS's 2010 Physician Fee Schedul... Read more
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... Read more
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 ... Read more
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... Read more
You Be the Expert:
Unwrinkle Nursing Facility POS Codes
Question: Our optometrists sometimes go to see patients in nursing homes. What criteria s... Read more
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 ... Read more
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... Read more
Reader Question:
Try V45.89 for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our optometrists ... Read more
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 ... Read more
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... Read more
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 ... Read more
You Be the Expert:
Code Misdirected Eyelashes in the Right Direction
Question: What are the correct modifiers for 67820? Pennsylvania Subscriber Answer: Code ... Read more
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... Read more
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... Read more
Reader Question:
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later ... Read more
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... Read more
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... Read more
Reader Question:
Specify Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requir... Read more
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... Read more
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... Read more
You Be the Expert:
VF Defect Due to Pituitary Adenoma
Question: How would you code a visual field defect arising from pituitary adenoma? Florid... Read more
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... Read more
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... Read more
Reader Question:
Don't Include Refraction Services in Exams
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscriber An... Read more
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... Read more
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... Read more
Reader Question:
Let Payers Reduce Your Multiple Procedure Fees
Question: Are insurance companies allowed to reduce our fees for multiple procedures perf... Read more
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... Read more
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... Read more
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... Read more
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... Read more
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 ... Read more
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 ... Read more
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 ... Read more
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... Read more
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 ... Read more
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... Read more
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... Read more
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 ... Read more
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 ... Read more
Report EOM Function Test With E/M
Question: The optometrist wants to code for a "detailed evaluation of EOM function." The ... Read more
Reader Question:
Deconstruct Code 92014
Question: Can you help me break down the guidelines for 92014? How many exam elements mus... Read more
Reader Question:
Unpack Fundus Photos From Exam Bundle
Question: Is fundus photography bundled with an office visit or consultation? California ... Read more
Reader Question:
Justify Medical Necessity for Gonioscopy
Question: How often can a gonioscopy test be performed on a patient? New Jersey Subscribe... Read more
Reader Question:
Spread Out FP and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fundus photogra... Read more
Reader Question:
Geography Affects Your Payments
Question: My optometrist has asked me to explain how to figure out what our reimbursement... Read more
2 Tips Lead to Proper Glaucoma Visit Coding
Let form and severity drive your coding choice. Often, optometrists find themselves in a b... Read more
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 ... Read more
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... Read more
Correction:
Correction:
An article in Vol. 7, No. 3 of the Optometry Coding & Billing Alert, "Prevent Uni-Bi R... Read more
Better Collections Rates Start With Better Collections Skills
Well-trained billers may be your biggest assets toward improved collections. With the dec... Read more
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... Read more
READER QUESTIONS:
Let Disease Damage, Control Drive VF Coding
Question: How often will Medicare allow visual field testing (92081-92083) on a patient? ... Read more
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... Read more
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... Read more
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... Read more
READER QUESTIONS:
Can Assistant Perform Laser Scan?
Question: What level of supervision is required for an ophthalmic assistant conducting a ... Read more
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 ... Read more
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. ... Read more
Play by Transfer of Care Rules
It pays to make sure transfers of care are by the book  -- the Office of the I... Read more
Part 2:
Perfect Your Non-Par Collections With These Options
Prevent hundreds from running out the door with these expert tips. ... Read more
Correction:
Correction:
A Reader Question in Optometry Coding & Billing Alert Vol. 12, No. 2 (Weigh Eye ... Read more
READER QUESTIONS :
Medicare Wants 1-Line Entry for Mod 50
Question: I need some information on billing bilateral procedures. For Medicar... Read more
READER QUESTIONS :
Follow Up to Recoup Missed Payments
Question: Ive landed a job with a practice where no one seems to follow up on ... Read more
READER QUESTIONS :
Specify Tech vs. Physician With Lens Codes
Question: My optometrist sees routine patients for services such as contact le... Read more
READER QUESTIONS :
Office Visit OK With Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision trainin... Read more
READER QUESTIONS :
Bill Most Appropriate Code, Regardless of Payment
Question: We keep getting denials on certain codes from certain payers. The op... Read more
Clear Up Diabetic Coding Confusion with These 3 Expert Tips
Hint: Make sure your specific diabetic Dx matches that of the patients primary... Read more
Compliance News:
Think Red Flags Rule Doesn't Affect You? Think Again
Get to know new identity theft rules that many optometry practices overlook. ... Read more
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... Read more
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... Read more
BUILD A BETTER BUSINESS:
Perfect Your Non-Par Collections With These Options
Prevent hundreds from running out the door with these expert tips. ... Read more
READER QUESTIONS:
E/M With 68761? Check Documentation First
Question: When I do a comprehensive exam (92004) and decide to insert punctal ... 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 inc... Read more
READER QUESTIONS:
Conduct Self-Audits at Least Annually
Question: Is it important for our office to perform self-audits regularly, or ... Read more
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... Read more
PQRI:
Make Sure These Errors Don't Cause Your PQRI Bonus to Tank
CMS shows which issues sidelined these practices. Most optometry pr... Read more
You Be the Expert:
Diagnosis Coding for Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim... Read more
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 ... Read more
BUILD A BETTER BUSINESS:
Don't Be Left Empty-Handed -- Bill the Patient
You dont necessarily have to forgo payment due to denial. Streamlin... Read more
READER QUESTIONS:
Check Medical Necessity Rules for 92025
Question: What are the rules for coding corneal topography? I cant find a CPT ... Read more
READER QUESTIONS:
Can You Code E/M for New-Patient FBR?
Question: A new patient came in today complaining of a foreign body sensation ... Read more
READER QUESTIONS:
Describe Follow-Up Visits Accurately With V Codes
Question: If a patient receives treatment and the condition was resolved, whic... Read more
READER QUESTIONS:
Base Total RVU Calculations on 3 Details
Question: How do I determine which RVUs to use in the Medicare fee schedule fo... Read more
READER QUESTIONS:
Enter the Paper vs. Electronic Claims Debate
Question: Does Medicare accept paper claims anymore? Ive heard that all claims... Read more
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 ... Read more
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... Read more
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... Read more
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 ... Read more
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... Read more
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... Read more
Reader Questions:
Check Secondary Payer Copay Rules
Question: A patient's primary insurance had a $15 copay, which we collected from the pati... Read more
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
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... Read more
You Be the Expert:
Glaucoma Follow-Up Visit
Question: How should I code an office visit for a wheelchair-bound nursing home patient wh... Read more
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... Read more
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 ... Read more
Corneal Pachymetry Payments Stay Solid
Calculate Fees Differently in 2009Here's how the BNA adjustment and the new conver-sion fa... Read more
Reader Questions:
Make Up Difference for Progressive Lenses
Question: I'm a little confused about coding for optical supplies. One of our patients got... Read more
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... Read more
Reader Questions:
Clear Up Filing Deadline Issues With Chart
Question: Our practice keeps getting denials because we are missing timely filing deadline... Read more
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