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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
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
ICD-10 Bridge
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
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
You Be the Expert:
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
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
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
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
ICD-10 Bridge
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
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
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
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
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
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
Reader Question:
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
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:
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
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
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
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
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
Reader Question:
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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