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Optometry Coding & Billing Alert
Optometry Coding & Billing Alert
Optometry Coding & Billing Alert - 2010; Volume 8, Number 12
Visual Fields:
92082 or 92083? Choose Wisely With This Expert Strategy
With over $70 on the line, don't risk submitting the wrong code or inadequate documentatio...
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News You Can Use:
Congress Boosts Conversion Factor Through Dec. 31
Medicare Physician Fee Schedule rate won't be cut 23 percent. Although the government app...
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OIG Update:
Practices Collected Over $8 Million for Services Rendered After Patients Died
OIG identified massive overpayments for services rendered after patients' dates of death....
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You Be the Expert:
Plaquenil Exam
Question: What diagnosis code should we use for OCT when the patient is currently on Plaq...
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Build a Better Business:
Has a Broken Payment Agreement Come to Dismissal?
Take these steps to end a practice/patient relationship without drama. If you have a pati...
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Reader Questions:
Spread Out 92250 and OCT Tests
Question: My Medicaid carrier just requested repayment for all claims for fundus photogra...
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Reader Questions:
Beware Tacking on Additional Patient Charges
Question: Can you charge a processing fee or a "statement" fee to past due patients when ...
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Reader Questions:
Don't Bill Under Another Provider's ID
Question: An optometrist in my office wants to bill services under another physician's ta...
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Reader Questions:
V67.00 Accurately Describes Follow-Up After Surgery
Question: If a patient receives treatment and the condition was resolved, which ICD-9 cod...
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Reader Questions:
Face Time Is Essential to Established Patient
Question: Our practice performed a test on a patient who was referred to us by another do...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 11
DME Reimbursement:
V2784 Strategies: Look to Modifiers KX, EY for Keys to DME Reimbursement
Keep medical necessity distinct from patient preference in documentation.If you're providi...
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Exam Coding:
Expand Your Coding Options For Patients Refusing Dilation
Tip: You can schedule a second office visit -- but beware this coding stipulation.You...
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Build a Better Business:
Navigate the Medicare Opt-Out Process in 3 Easy Steps
No Medicare does not equal no contracts.If you decided that 2011 is the year your practice...
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You Be the Expert:
PAM or VEP?
Question: Is 95930 the correct procedure code for potential visual acuity meter? Can this ...
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Reader Questions:
Dig In to Dry Eye Diagnosis
Question: Should I report a dry eye diagnosis code based on the optometrist's clinical fin...
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Reader Questions:
Save 'Foggy Vision' for Secondary Dx
Question: Many of our patients claim general reasons for their visit, such as "I can't see...
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Reader Questions:
No CCI Bundle? Here's Where to Find Modifier Details
Question: Sometimes I cannot find my two-code pair in the CCI edits. How do I know which c...
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Reader Questions:
Avoid Bilateral Modifiers on 76519, 92136
Question: The optometrist calculated IOL power in both a patient's eyes. Should I report t...
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Reader Questions:
Write-Off Doesn't Equal 1099
Question: We ended up writing off some patient balances as bad debts. Should we be sending...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 10
CPT 2011:
Prepare to Distinguish Between Optic Nerve and Retina Laser Scans
Tip: Your bilateral reporting options may change for SCODI next year.Frustrated by the lac...
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ICD-10:
Make Sure You're Ready: Get the ICD-10 Lowdown With Expert Guidelines
You'll need to implement the new 5010 claim form first to be ready for ICD-10. Whi...
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Overcome Delinquent Payer Headaches By Knowing Your State's Prompt Pay Laws
Remember: Medicare requires contractors to pay your clean claims within 30 days, but priva...
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You Be the Expert:
EOM Function Test
Question: My optometrist wants to code for a "detailed evaluation of EOM function." The di...
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Reader Questions:
Use 99201-99205 if Patient Switches to Your Office
Question: When I cover for another local private-practice optometrist, I code the office v...
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Reader Questions:
Avoid a 'Finders Keepers' Overpayment Mentality
Question: We've discovered that a patient overpaid us on her copay. We collected $50, whic...
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Reader Questions:
Code 92225 and 92250 Together When Medically Necessary
Question: When is it appropriate to bill for extended ophthalmoscopy and fundus photograph...
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Reader Questions:
Do Your Homework Before Hiring Outside Help
Question: Our practice just combined with another practice, and we're thinking about outso...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 9
Glaucoma Evaluation:
Determine Eligibility Before Looking to G0117 or G0118
The answers to the 2 questions below could bring $135 in to your practice.Choosing the cor...
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E/M Services:
Answer 'Separate' or 'Inherent' Question Before You Use Modifier 25
Not all pre-procedure services constitute a separate E/M.When an optometrist performs an E...
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Build a Better Business:
3 Steps Help You Uncover Missed Billing Opportunities With
Tip: The same audit process and timeline won't work for every office -- identify your...
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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 e...
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Reader Questions:
Prove Necessity for Large Bifocal Segs
Question: I'm really confused about codes V2219 and V2319 for Medicare patients. I know it...
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Reader Questions:
Understand Both Sides of Gonioscopy Coding
Question: I know that Medicare looks at gonioscopy as a bilateral procedure. What about ot...
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Reader Questions:
Can You Not Submit a Claim to a Payer?
Question: We have a patient who wants us to give her the allowable amounts for a procedure...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 8
Fundus Photos:
Appending Modifier 50 to 92250? Not So Fast
Snap up your rightful fundus photo pay with bundling, Dx know-how.Adding too many -- ...
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Myth Buster:
Don't Let These Bilateral Blunders Stall Your Pay for Pre-Cataract Surgery Tests
Improperly coding IOL Masters or A-scans can cost your practice $30 per patient.Calculatin...
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Build a Better Business:
Test Your Collections Skills With 5 Questions
Know what your options are for non-par patients.You know that solid collections knowledge ...
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You Be the Expert:
Irritated Pinguecula
Question: Which diagnosis code should I use for an irritated pinguecula?Connecticut Subscr...
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Reader Questions:
Forget Modifiers for Bilateral VF
Question: As a retina office, we occasionally do visual fields. However, when I report 920...
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Reader Questions:
Rule-Out Diagnosis Coding Is a No-No
Question: My optometrist occasionally sees patients, and instead of coming to a conclusive...
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Reader Questions:
Pay Attention to Individual State WC Rules
Question: We had a patient who was injured on the job (workers' compensation) in Virginia ...
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Reader Questions:
Get to Know Capitation Contracts
Question: I'm confused about what capitation actually is and how we bill under capitation ...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 7
Post-Op Care:
4 Tips Help You Recoup Full Pay for Cataract Co-Management
Your follow-up service begins the day after the ophthalmic surgeon relinquishes care.You k...
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News You Can Use:
Welcome a 2.2 Percent Medicare Pay Boost For the Rest of This Year -- Finally
But the news isn't all good -- first, you faced a week of lower payments, and second,...
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Build a Better Business:
Keep Your Payments Coming In By Focusing on Timely Filing
With the Medicare deadline cut from three years to one, using a chart can help.As the impa...
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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...
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Reader Questions:
Use Most Specific ICD-9 Code for Visual Fields Claims
Question: We keep getting denials for 92082 and 92083 (Visual field examination ...) linke...
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Reader Questions:
Don't Echo Echography Code
Question: I'm trying to submit a claim for 76514 performed on both eyes, but I've been get...
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Reader Questions:
Make Sure Your EHR Passes PQRI Muster
Question: We have been participating in the physician quality reporting initiative (PQRI),...
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Reader Questions:
Clarify Temp Services Using Modifier Q6
Question: Our regular optometrist is taking some time off, and a temporary optometrist tak...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 6
Diagnostics:
Read This Before Your Next Extended Ophthalmoscopy Claim
Ensure you know what qualifies as an EO, and go beyond routine coding.Most eye exams inclu...
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Modifiers:
Understand Eyelid Modifiers and Avoid Coding Confusion
Do you need E1-E4 for punctal plugs and epilation?Thanks to the abundance of bilateral cod...
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Build a Better Business:
Part 2: Don't Let Patients' Financial Hardship Become Yours
A clear financial hardship policy might prevent some write-offs.You have a head start on u...
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Reader Questions:
Unbundle Slit Lamp Photos and Gonioscopies
Question: Our optometrist saw a glaucoma patient and performed a gonioscopy. The optometri...
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Reader Questions:
Modify Eye Codes Just Like E/M Codes
Question: I just started working in an optometrist's office and I have a question about mo...
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Reader Questions:
Collect Medicare Copay Up Front
Question: We have many patients on Medicare in our practice. When a Medicare patient prese...
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You Be the Coder:
VFs Ordered by Outside Doctor
Question: We performed a visual field ordered by a doctor outside our practice. The patien...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 5
FBR:
Bust These Foreign Body Removal Myths for Foolproof Claims
Treating punctal plugs like FBRs? Read this first.Even more irritating than having somethi...
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ICD-10; Get the Real Story on ICD-10 With These Expert Answers
Hint: You will be able to find hard copy ICD-10 books -- and dozens of new cataract c...
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Build a Better Business:
Speed Up New Patient Data Capture With 5 Tips
Streamline your collections system and get your deserved money faster with these practice ...
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Reader Questions:
Don't File PRK Follow-Up by Second Optometrist
Question: We got a patient for a PRK follow-up exam. He had the surgery done at another fa...
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Reader Questions:
Conduct 3 Tests Before Coding Diurnal Curve Encounters
Question: Is there a code for "diurnal curve testing," during which the optometrist checks...
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Reader Questions:
Can Provider Change Tax ID?
Question: One of our optometrists wants to stop billing under the group's tax ID and start...
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Reader Questions:
Write Off Medicaid Secondary Balances
Question: A patient has a Medicare replacement plan and then has Medicaid as secondary ins...
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You Be the Coder:
Blepharitis Type Drives Diagnosis Coding
Question: What is the proper ICD-9 code for patients with blepharitis?Tennessee Subscriber...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 4
CPT:
6 Tips Guide You to More Accurate Contact Lens Claims
Clear the air on appropriate codes to boost practice revenue. Getting insurance claims pa...
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Build a Better Business:
Use an EHR System to Your Billing Advantage
Up-front costs could give way to savings in many areas. Streamline your collections syste...
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You Be the Expert:
Low-Risk Glaucoma Screenings
Question: Our office sometimes performs glaucoma screenings for patients who don't m...
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Reader Questions:
Does Old BB-Gun Injury Have Bearing on Coding?
Question: We have a patient who came in for a routine eye exam, but reported retinal dama...
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Reader Questions:
Don't Put Suspended Claims on the Back Burner
Question: My office has a few claims that have missing or incorrect information. I'm new ...
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Reader Questions:
Apply Initial EO Code to New Condition
Question: I'm confused about the extended ophthalmoscopy codes. Is 92225 for a new patien...
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Reader Questions:
Face Time Is Essential to Established Patient
Question: Our practice performed a test on a patient who was referred to us by another do...
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Reader Questions:
Billing Before Credentialing? Check With Carrier
Question: Our practice is expanding and we will soon have two new optometrists starting w...
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Reader Questions:
3 Details Drive RVU Calculations
Question: How do I determine which RVUs to use in the Medicare fee schedule for rei...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 3
4 Tips Point the Way to Crystal-Clear OCT Coding
Learn when you can, and should, report 92135 more than once to gain $44. When y...
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Watch Key Conditions to Scratch Eye Allergy Coding Itch
Get the specifics on eye irritation to find the most accurate diagnosis code. The sprin...
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You Be the Expert:
Find the Right Dx for Pseudostrabismus
Question: What ICD-9 code should I report for a diagnosis of pseudostrabismus? Arizona ...
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News You Can Use:
CMS Clamps Down on Physician Signature Requirement
CERT has contractors denying claims that would have squeaked by in 2008. CMS has releas...
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Build a Better Business:
Update Your PECOS File Now to Ensure Payment Later
Hint: You'll need the system's electronic funds transfers in order to get paid. Streaml...
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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...
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Reader Questions :
Use Patient Complaint for FBR Coding
Question: I saw a patient yesterday who had a conjunctival foreign body. I billed 65205 a...
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Reader Questions :
Ease the Pain of Confirming Patient Information
Question: We update important patient information,such as insurance, address, emergency c...
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Reader Questions :
Look Into Options for Handling Late or No-Show Patients
Question: We have a few patients who routinely miss appointments or show up late. We'd li...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 2
Get to Know Payer Specifics for Gonioscopy
3 FAQs clear up your 92020 coding to improve your claims' success. With only one code for...
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You Be the Expert:
Aim for Proper Ametropia ICD-9 Code
Question: Which ICD-9 code should I report for ametropia? Kansas Subscriber Answer: ...
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Resolve 'Medical vs. Vision' Insurance Coding Mixups
When your patient has both types of insurance, who gets the bill? Let the reason for the v...
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Build a Better Business:
Don't Let Patients' Financial Hardship Become Yours
Discounts and write-offs are options, if you follow these guidelines. That a patient may ...
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READER QUESTIONS:
Document Chief Complaint for Glaucoma Follow-Up
Question: How should I code an office visit for a wheelchair-bound nursing home patient w...
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READER QUESTIONS:
Find 'Track or Treat' Evidence for 92285 Claims
Question: Our optometrist performs external ocular photography for a Medicare patient wit...
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READER QUESTIONS:
Check to See If CMS Signed You Into PECOS
Question: I keep hearing about PECOS, but I'm so confused about the whole thing. Do I nee...
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READER QUESTIONS:
Understand Your Obligations for Overpayments
Question: Some insurers are deducting overpayments from our checks for visits or services...
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READER QUESTIONS:
Append GY to Refraction Claims
Question: A doctor recently told me that appending modifier GY to the refraction code wou...
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Optometry Coding & Billing Alert - 2010; Volume 8, Number 1
Make Sure Techs' Work Meets Incident-To Standard
Their services can boost the E/M level -- but the OIG is always watching. If an audi...
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News You Can Use:
Legislators Offer New Year's Gift With Temporary Pay Fix
You'll face a 10-day delay from MACs as they update their claims systems. Good news: Desp...
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CMS's Refusal to Pay Consults Makes MSP Claims a Headache
If you bill 99241-99255 to private payers, good luck getting Medicare secondary balance. ...
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Build a Better Business:
Weigh Pros and Cons Before Kissing Medicare Goodbye
Reduced patient pool, satisfaction may trump easier payment process. With the threat of s...
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You Be the Expert:
Unilateral Visual Fields
Question: I'm confused about coding for visual fields (VF). The code description says "un...
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Reader Question:
Don't Change Insertion Code by Plug Type
Question: We use both temporary and permanent punctal plugs. Should I code differently fo...
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Reader Question:
Beware Reporting Fundus Photos With HRT
Question: Can I report a fundus photo and a Heidelberg retina tomograph (HRT) on the same...
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Reader Question:
Give Collections Agencies All the Details
Question: We've decided to turn over some of our outstanding accounts to a collection age...
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Reader Question:
Avoid Underpayment From SNFs With a Contract
Question: We consistently have trouble collecting for services our physicians provide to ...
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