Optometry Coding & Billing Alert
CPT® 2012 Update:
92070 For Therapeutic Contacts? Not Anymore
New codes 92071 and 92072 carry the load for lens prescriptions for keratoconus and OSD.Al... Read more
92070 For Therapeutic Contacts? Not Anymore
New codes 92071 and 92072 carry the load for lens prescriptions for keratoconus and OSD.Al... Read more
Part B Payment:
Congress Votes to Boost Conversion Factor Through February 29.
At nearly the last minute, lawmakers ensure that you won't lose 27 percent.Although the go... Read more
Congress Votes to Boost Conversion Factor Through February 29.
At nearly the last minute, lawmakers ensure that you won't lose 27 percent.Although the go... Read more
ICD-10 Bridge
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be differe... Read more
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be differe... Read more
E/M:
HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately ac... Read more
HPI Know-How Helps You Catch Level 4 and 5 E/M Opportunities
Beware of CPT® and Medicare differences when counting HPI elements.Not accurately ac... Read more
4 Tips Help You Successfully Collect for Services When Your Practice Does Not Participate
Hint: Collecting early is often the key.As payer contracts get more and more complicated a... Read more
Hint: Collecting early is often the key.As payer contracts get more and more complicated a... Read more
You Be the Expert:
Exophthalmometry
Question: Is there a CPT® code for exophthalmometry?Georgia SubscriberAnswer: ... Read more
Exophthalmometry
Question: Is there a CPT® code for exophthalmometry?Georgia SubscriberAnswer: ... Read more
Reader Question:
List Referring Doctor's Name for Pachymetry
Question: I am billing pachymetry (76514, 1 unit) with a diagnosis code of 365.04 (Ocular ... Read more
List Referring Doctor's Name for Pachymetry
Question: I am billing pachymetry (76514, 1 unit) with a diagnosis code of 365.04 (Ocular ... Read more
Reader Question:
Base Billing Order on RVU Order
Question: I know that as a general rule the highest RVU has a higher billed amount an... Read more
Base Billing Order on RVU Order
Question: I know that as a general rule the highest RVU has a higher billed amount an... Read more
Reader Question:
Verify Copay Early to Save Time, Money
Question: A patient came to our office with the same insurance card she's had for years. W... Read more
Verify Copay Early to Save Time, Money
Question: A patient came to our office with the same insurance card she's had for years. W... Read more
Lens Services:
92070 With 371.6x Focuses on Medical Necessity for Fitting Keratoconic Lenses
Follow this strategy and earn $67 for each contact lens procedure.You know you can't bill ... Read more
92070 With 371.6x Focuses on Medical Necessity for Fitting Keratoconic Lenses
Follow this strategy and earn $67 for each contact lens procedure.You know you can't bill ... Read more
ICD-10 Bridge
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be differe... Read more
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be differe... Read more
CPT® 2012:
Establish Whether A Patient is New With CPT®'s Latest E/M Tweaks
New rules place emphasis on subspecialties. It's an age-old debate --when an established p... Read more
Establish Whether A Patient is New With CPT®'s Latest E/M Tweaks
New rules place emphasis on subspecialties. It's an age-old debate --when an established p... Read more
5010 Readiness:
Medicare Won't Penalize You for 5010 Non-Compliance Until March 31, 2012
Plus: Avoid PO boxes on 5010, despite what your MAC tells you.Sweating over the fact that ... Read more
Medicare Won't Penalize You for 5010 Non-Compliance Until March 31, 2012
Plus: Avoid PO boxes on 5010, despite what your MAC tells you.Sweating over the fact that ... Read more
Build a Better Business:
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key.You've heard the mantra over and over ... Read more
Don't Overlook Waiver Opportunities -- 3 Steps Ensure Compliance and Patient Payment
Hint: Documented financial hardship is your key.You've heard the mantra over and over ... Read more
You Be the Expert:
Dx for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our optometrists p... Read more
Dx for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our optometrists p... Read more
Reader Question:
92225-92226: Apply Initial EO Code to New Condition
Question: I'm confused about the extended ophthalmoscopy codes. Is 92225 for a new patient... Read more
92225-92226: Apply Initial EO Code to New Condition
Question: I'm confused about the extended ophthalmoscopy codes. Is 92225 for a new patient... Read more
Reader Question:
68761 With E/M? Check Documentation First
Question: When my optometrist does a comprehensive exam (92004) and decides to insert punc... Read more
68761 With E/M? Check Documentation First
Question: When my optometrist does a comprehensive exam (92004) and decides to insert punc... Read more
Reader Question:
Know When to Bill Secondary Payer
Question: We have many patients with secondary insurance, some of which have deductibles o... Read more
Know When to Bill Secondary Payer
Question: We have many patients with secondary insurance, some of which have deductibles o... Read more
ICD-9 Coding:
Nonspecific Complaints? 368.8 Is Only the Beginning of Your Options
If a patient has 'blurred vision,' there must be a reason-- find the cause and save your p... Read more
Nonspecific Complaints? 368.8 Is Only the Beginning of Your Options
If a patient has 'blurred vision,' there must be a reason-- find the cause and save your p... Read more
ICD-10 Bridge:
ICD-10 Bridge:
Once ICD-10 is implemented, the diagnosis codes in the above story will be different. Chec... Read more
ICD-10 Bridge:
Once ICD-10 is implemented, the diagnosis codes in the above story will be different. Chec... Read more
ICD-10:
Prepare for ICD-10 Conversion With 2 Simple Tips
Know your anatomy and physiology if you want a quick transition.It's not too early to star... Read more
Prepare for ICD-10 Conversion With 2 Simple Tips
Know your anatomy and physiology if you want a quick transition.It's not too early to star... Read more
Collections Q&A:
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert.Having a financia... Read more
Create a Solid Financial Policy That Tells Your Patients Exactly What You Expect
Get answers to your top financial policy questions from a billing expert.Having a financia... Read more
You Be the Expert:
Diagnosis Code for Normal VF
Question: We had a patient present with high intraocular pressure, a sign of glaucoma, and... Read more
Diagnosis Code for Normal VF
Question: We had a patient present with high intraocular pressure, a sign of glaucoma, and... 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, ... Read more
Don't Code Fundus Photos Bilaterally for Medicare
Question: Our new software program instructs us to append modifier 50 to code 92250, ... Read more
Reader Question:
Cookie Cutter Appeal Letters Won't Bring In the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
Cookie Cutter Appeal Letters Won't Bring In the Cash
Question: After checking to be sure we haven't made a coding or billing entry error, our p... Read more
Reader Question:
List As Many PQRS Codes As Needed
Question: Can we report more than one PQRS code measure on the same claim?Virginia Subscri... Read more
List As Many PQRS Codes As Needed
Question: Can we report more than one PQRS code measure on the same claim?Virginia Subscri... Read more
Reader Question:
Perfect Your Payer Fee Schedule
Question: We're getting ready to begin contract renewal negotiations with one of our payer... Read more
Perfect Your Payer Fee Schedule
Question: We're getting ready to begin contract renewal negotiations with one of our payer... Read more
Cataract Co-Management:
66984 Tips: Coordinate With Surgeon to Ensure Your Fair Reimbursement
Hint: Check the original coding before you report 366.10 every time.When more than one doc... Read more
66984 Tips: Coordinate With Surgeon to Ensure Your Fair Reimbursement
Hint: Check the original coding before you report 366.10 every time.When more than one doc... Read more
Part B Mythbuster:
These 4 Deadly Myths Could Damage Your Practice
Setting your 92014 fees higher for Medicare patients could land your optometry practice in... Read more
These 4 Deadly Myths Could Damage Your Practice
Setting your 92014 fees higher for Medicare patients could land your optometry practice in... Read more
Build a Better Business:
Keep Your Practice Out of Hot Water By Knowing When You Can -- and Can't -- Write Off a Patient Balance
Don't try to skirt around the system or you'll end up on the audit radar.Being a compassio... Read more
Keep Your Practice Out of Hot Water By Knowing When You Can -- and Can't -- Write Off a Patient Balance
Don't try to skirt around the system or you'll end up on the audit radar.Being a compassio... Read more
You Be the Expert:
EO for Flashers and Floaters
Question: A patient reports flashes and floaters but the optometrist does not find evidenc... Read more
EO for Flashers and Floaters
Question: A patient reports flashes and floaters but the optometrist does not find evidenc... Read more
Reader Questions:
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later f... Read more
Give the Full Picture on Fundus Photos
Question: If you perform 92250 (fundus photography) on a patient with diabetes and later f... Read more
Reader Questions:
VF & Temp Plugs: How Many Modifiers?
Question: A patient came in for visual field (VF) tests. During the same visit, the optome... Read more
VF & Temp Plugs: How Many Modifiers?
Question: A patient came in for visual field (VF) tests. During the same visit, the optome... Read more
Reader Questions:
Update Your Software and Billing With 2011 CPT Modifier Changes
Question: We read lots of information about CPT 2011 code changes, but are there any modif... Read more
Update Your Software and Billing With 2011 CPT Modifier Changes
Question: We read lots of information about CPT 2011 code changes, but are there any modif... Read more
Reader Questions:
Is 368.8 the Right Dx for 'Foggy Vision'
Question: Many of our patients claim general reasons for their visit, such as "I can't see... Read more
Is 368.8 the Right Dx for 'Foggy Vision'
Question: Many of our patients claim general reasons for their visit, such as "I can't see... Read more
Bilateral Billing:
Make the Most of Modifier 50 for Bulletproof Bilateral Claims
Hint: Check code descriptions for clues that a procedure can be billed as unilateral.Don't... Read more
Make the Most of Modifier 50 for Bulletproof Bilateral Claims
Hint: Check code descriptions for clues that a procedure can be billed as unilateral.Don't... Read more
Part B Payment:
CMS Tweaks 2011 Conversion Factor
Despite adjusted rate of 33.9764, changed RVUs should ensure that your payments will stay ... Read more
CMS Tweaks 2011 Conversion Factor
Despite adjusted rate of 33.9764, changed RVUs should ensure that your payments will stay ... Read more
Build a Better Business:
Clearly Outline Practice Expectations With No Show Letters and Fees
Check your payer rules before charging your patients.Every practice has the occasional pat... Read more
Clearly Outline Practice Expectations With No Show Letters and Fees
Check your payer rules before charging your patients.Every practice has the occasional pat... Read more
Reader Questions:
Explore CCI, Fee Schedule for Modifier Details
Question: We sometimes get denials that appear to be related to bundling issues but I can'... Read more
Explore CCI, Fee Schedule for Modifier Details
Question: We sometimes get denials that appear to be related to bundling issues but I can'... Read more
Reader Questions:
Office Visit OK With Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision training on the sam... Read more
Office Visit OK With Vision Training
Question: Can we submit 99213 for an office visit and 92065 for vision training on the sam... 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 in the right... Read more
Can You Code E/M for New-Patient FBR?
Question: A new patient came in today complaining of a foreign body sensation in the right... Read more
Reader Questions:
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 not... Read more
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 not... Read more
Reader Questions:
New Year, New Insurance = New Verification
Question: How should I file a claim on a patient who has new coverage but has not received... Read more
New Year, New Insurance = New Verification
Question: How should I file a claim on a patient who has new coverage but has not received... Read more
Reader Questions:
Can Provider Change Tax ID?
Question: One of our physicians wants to stop billing under the group's tax ID and start b... Read more
Can Provider Change Tax ID?
Question: One of our physicians wants to stop billing under the group's tax ID and start b... Read more
You Be the Coder:
92225 Done Twice May Need Different Dxs
Question: Could you shed some light on billing 92225 or 92226 with modifier 50, RT/LT, or ... Read more
92225 Done Twice May Need Different Dxs
Question: Could you shed some light on billing 92225 or 92226 with modifier 50, RT/LT, or ... Read more