Advanced Search

Optometry Coding & Billing Alert

Diagnosis Coding:
373.0, 375.15, or 372? Get Specifics on Eye Irritation to Find Best Dx Code
Tip: Make sure to consider the prime reason for the visit in your coding. Spring is he... Read more
CPT® 2014:
99446-99449: New E/M Codes Capture Doc Discussions
Make sure to include a written report. Who knows if Medicare will pay, but you should ... Read more
E/M:
Navigate the New-Versus-Established-Patient Maze With Expert Tips
Different locations, same physician? Use established patient codes. When reporting man... Read more
EHR Mythbuster:
3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are... Read more
You Be the Expert:
EOM Function Test
Question: My optometrist wants to code for a “detailed evaluation of EOM function.... Read more
Reader Question:
Test Your ICD-10 Coding in March
Question: I have heard that there will be a test period for using ICD-10 codes on claims... Read more
Reader Question:
Know How to Email Without Violating HIPAA
Question: I sometimes e-mail patient records to consultants for help on how to bill. How... Read more
Reader Question:
Opt for First-Initial, Last-Name Privacy Protocol
Question: What guidelines should our group follow to protect the privacy of patient info... Read more
Visual Fields:
Clarify Your VF Coding for Glaucoma Suspects
Follow these three tips for solid 92081-92083 claims. Optometrists usually spend a lot... Read more
ICD-10 Update:
Don't Get Sidelined By These 3 ICD-10 Myths
Don’t assume that ICD-10 will allow you to use the same code twice. With the hea... Read more
Compliance:
Bust These 5 Common Compliance Myths
Tip: Make a good faith effort to comply with the spirit of the law. Don’t get wa... Read more
PQRS:
Review the PQRS Group Reporting Details to Secure Your Bonus Pay
How you’ll report depends on the number of providers in your group. If your prac... Read more
You Be the Expert:
Post-Op YAG Management
Question: We’re having trouble filing for postoperative care for a YAG. How should... Read more
Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requi... Read more
Reader Question:
CMS Clarified Unencrypted Email Prohibition
Question: I recently heard that the HIPAA privacy rule was changed and it now prohibits ... Read more
Reader Question:
Legibility Matters, CMS Stresses
Question: I have heard payers are cracking down on illegible provider documentation. My ... Read more
CCI Update:
CCI Suspends Edits Bundling 92012, 92014 Into Hundreds of Procedures
Claims processing problem prevented modifier 25 from unbundling procedures, CMS says. ... Read more
Advance Beneficiary Notices:
Adding 'G' Modifiers on Your Medicare Claims? Expect Extra Scrutiny
The OIG report puts GA, GZ, GY, and GX in the hot seat. When your practice is billing ... Read more
HIPAA:
Solidify Your HIPAA Policies and Practices Before the Auditors Come Knocking
All covered entities and business associates are on the audit list, HHS says. HIPAA is... Read more
EHR Mythbuster:
3 EHR Myths That Could Cost Your Practice Heavily
Warning: Blindly relying on your electronic system could mean payer audits. If you are... Read more
You Be the Expert:
Refraction Services
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscriber... Read more
Reader Question:
Clear Up Modifier 59 Confusion
Question: We were just notified that modifier 59 is no longer accepted by Medicare ... Read more
Reader Question:
MSP Doesn't Change Medicare Consultation Pay
Question: I know Medicare doesn’t reimburse consults anymore, but a new coder... Read more
Pre-Cataract Surgery Tests:
76519, 92136: Understand Bilateral Rules and Receive Fair Reimbursement
Check out these common IOL power calculation myths — is one of them tripping up yo... Read more
Associated Diagnoses
Medicare covers IOL calculation procedures for patients about to undergo cataract surger... Read more
ICD-10:
Conversion to ICD-10 Won't Be A Huge Financial Burden, CMS Reps Say
Plus: ICD-10 claims will allow you to submit the letters as either upper or lowercase, C... Read more
Compliance:
E/M Errors Top Medicare's List of Improperly Billed Codes in 2012
CERT results reveal $29.6 billion in improper Medicare payments — $1.1 billion of ... Read more
Practice Management:
Breeze Through HIPAA Audit With 5 Protocol Tips
Try your hand at internal audits first. Random and targeted HIPAA audits are making th... Read more
You Be the Expert:
Angle Kappa Measurement
Question: We perform a measurement called angle kappa to help in calculating and choosin... Read more
Reader Question:
Calculate the Sequestration Cut Effects
Question: Does the 2 percent sequestration cut apply to claims with dates of service on/... Read more
Diagnostics:
Reporting 92100 or 92225 Bilaterally? Read This First
Modifiers are they key that can, in some cases, unlock double the reimbursement. Most ... Read more
Part B Payment:
Proposed 2014 Fee Schedule Suggests Steep Cuts
But in 2015, practitioners could finally see bonuses for non-face-to-face services admin... Read more
ICD-10 Prep:
Let 4 FAQs Help Guide Your ICD-10 Focus
Don’t limit your training to code selection alone. The ICD-10 implementation de... Read more
You Be the Expert:
Post-Op Exam With Unrelated Complaint
Question: We did a general eye exam at the patient’s request within the three-mont... Read more
Reader Question:
76514 Suffices for Bilateral Pachymetry
Question: I’m trying to submit a claim for 76514 performed on both eyes, but I&rsq... Read more
Reader Question:
379.31 Proves Necessity for V2219
Question:  I’m really confused about codes V2219 and V2319 for Medicare patie... Read more
Reader Question:
Don't Hold Your Breath for Medicare Phone Call Pay
Question: Another physician told my doctor that he’s receiving payment from his co... Read more
A-Scans:
Modify 76511, 76516, 76519 Correctly for Proper Reimbursement
LT, RT, and TC modifiers are key, experts say. A-scans are some of the most common pro... Read more
HIPAA How-To:
Review Your Business Associate Agreements Before the Feds Come Knocking
You have until September to get a handle on the recent changes. Now that the omnibus r... Read more
Billing:
Brush up on Overpayment Policies Now That CMS Has 5 Years to Request Refunds
Keeping overpayments can get you in hot water with patients, payers, and the law. If y... Read more
You Be the Expert:
Same Day, Different Procedure Visits
Question: A patient pays a visit to the clinic for a routine eye exam in the morning. CP... Read more
Reader Question:
Don't Include Refraction Services in Exams
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscrib... Read more
Reader Question:
Mitigate Late Patient Costs With Block Scheduling
Question: Recently we have had a lot of patients showing up late for appointments. The p... Read more
FBR:
Don't Be Blind to 3 Factors When Coding Ocular Foreign Body Removals
Look closely at the documentation for these clues to determine the right code assignment... Read more
Documentation:
Leave the HPI Details to the Provider
Identify which portions of the record ancillary staff can capture. Your time is valua... Read more
Electronic Medical Records:
Look Before Jumping on the EMR Bandwagon
Picking the wrong EMR system could mean losing money and system blackouts. Electronic ... Read more
You Be the Expert:
Epilation of Lashes
Question: What is the proper way to code for epilation of lashes? We used to bill per la... Read more
Reader Question:
Brush Up on ICD-10 Differences
Question: I’ve seen lots of specific examples of ICD-10 codes, but I think it woul... Read more
Reader Question:
92015-92140 and 92002-92014 Can Mix
Question: Can the special ophthalmological services be provided and reported with the ge... Read more
Cataract Co-Management:
2 Pointers Keep Your Post-Op Cataract Care Coding on Track
Hint: Coordinate with the surgeon and always check the original coding. When more than... Read more
Part B Mythbuster:
Check Out These Top 5 ABN Myths
These surprising CMS rules on ABN use are straight from Medicare policy. You’ve ... Read more
Office Visits:
Boost Your E/M Bottom Line With These Quick Tips
Chief complaint shouldn’t be ‘follow-up.’ E/M coding might be part o... Read more
Sequester Cuts:
Medicare Advantage Taking a 2 Percent Bite? Bite Back
Unless your contracts specifically allow your MAO to pass on its two percent cuts to you... Read more
Billing:
Follow This 3-Step Advice Before Waiving Copays
Tip: Get your own verification of financial hardship. Every physician wants to collect... Read more
You Be the Expert:
EO for Flashes and Floaters
Question: A patient reports flashes and floaters but the optometrist does not find evide... Read more
Reader Question:
Amend Documentation With Care
Question: One of our optometrists wants to amend documentation of a procedure, but we do... Read more
Gonioscopy:
92020 FAQ: Watch Bilateral Status, Diagnoses for Gonioscopy
There may only be one gonioscopy code, but there are several ways you can sabotage your ... Read more
Cash Flow:
5 Hidden Income Opportunities Ease the Pain of Sequestration Cuts
Your Medicare pay was slashed by 2 percent on April 1 — these tips will help bring... Read more
Consolidated Billing:
Follow 3 Tips to Ensure You Properly Bill Services for Nursing Facility Patients
Don’t wait to check the patient’s status until you are ready to file a claim... Read more
You Be the Expert:
Unilateral 92133
Question: A primary care physician instructed one of our patients to see an eye doctor a... Read more
Reader Question:
Wait Until Oct. 1, 2014, to Use ICD-10
Question: Our practice is considering submitting claims with ICD-10 codes before the imp... Read more
Reader Question:
Let Medical Necessity Rule Code Choice
Question: Our optometrist  is a very thorough documenter and treats very sick patie... Read more
Reader Question:
Quality Measures Get Added to Contract Equations
Question: I’ve heard that quality issues will become a bigger part of contract neg... Read more
ICD-9 Coding:
Blurred Vision? Dry Eye? FBR? Look to These Dx Options
Tip: Find the cause of these nonspecific complaints to arrive at the correct diagnosis c... Read more
Practice Management:
Learn the Basics Before Investing in Practice Management Software
The right tools can streamline your administrative and financial tasks. Medical practi... Read more
News You Can Use:
You're Saved From 26.5 Percent Physician Pay Cut
But RVU changes still in effect. Optometrists can expect a reprieve from the dreaded 2... Read more
Don't Settle:
Perform an MPM Needs Analysis
Review these system features and decide which ones your practice needs. When your prac... Read more
Documentation:
Need to Amend a Patient Encounter? Better Check These Directions First
Heads up: Single-line corrections are fine. If you discover your optometrist forgot to... Read more
Ordering/Referring:
6 Steps Help You Reduce PECOS Edit Losses
Tip: Check your current referring info to avert financial crisis in May. You’d b... Read more
You Be the Expert:
Unilateral 92133
Question: We performed an OCT on a patient’s left eye, and filed the claim with 92... Read more
Reader Question:
365.01 Describes Dx for Normal VF
Question: We had a patient present with high intraocular pressure, a sign of glaucoma, a... Read more
Reader Question:
Keep a Record of Your Provider's Signature Variations
Question: We’re having trouble making sure our providers meet signature requiremen... Read more
Diagnostic Tests:
92225-92226 Coding: Get to Know These Guidelines for Extended Ophthalmoscopy
With $27 on the line each time, staying on top of carrier rules is critical. Many opt... Read more
Practice Management:
Get Ready For OIG Scrutiny of Modifiers and More
Audit yourself before the feds come calling. Your optometry practice could come under ... Read more
Visual Fields:
Don't Pick Intermediate VF Code When Extended Code Is Justified
Choosing between 92082 or 92083 can be tricky -- let our expert advice guide you. ... Read more
E/M Coding:
Implement These 5 Simple Steps to Boost Your E/M Bottom Line
Heads up: Dig past ‘follow-up’ for acceptable chief complaint. E/M coding ... Read more
You Be the Expert:
Foggy Vision
Question: Many of our patients claim general reasons for their visit, such as "I ca... Read more
Reader Question:
Clear Up Secondary Payer Confusion
Question: We have many patients with secondary insurance, some of which have deductibles... Read more
Reader Question:
No New Code Describes Paperwork
Question: I’ve heard that CPT® has a new code for reviewing records separate f... Read more
Reader Question:
Inform Patients Before Collecting Co-Pays Up Front
Question: One of our providers returned from a meeting, saying he had talked to other pr... Read more
Lens Services:
92072, Not 92310, Is Best Bet for Keratoconus Lenses
Be sure documentation proves medical necessity. You know you can’t bill Medicare... Read more
EHR:
Does Your Electronic Prescription System Pass Muster?
Get started now to avoid further pay hits in 2014. Incentives for using electronic pre... Read more
2013 Payment:
Last-Minute Congressional Vote Reverses Across-the-Board Pay Cuts
Medical societies still hopeful for new formula to halt this annual nail-biter. As man... Read more
Documentation:
Avoid Billing E/M Service Based on Cloned Documentation, Or the OIG Will Come Knocking
Ensure your EMR is not setting you up for failure. If you have reviewed the HHS Offic... Read more
Overpayments:
Medicare Now Has 5 Years to Request Money Back From Your Practice
Previous 3-year lookback period was extended with ‘fiscal cliff’ legislation... Read more
You Be the Expert:
Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim. The opto... Read more
Reader Question:
Consider V45.69 for Post-LASIK Cataracts
Question: A patient who has had LASIK surgery now has cataracts. One of our optometrists... Read more
Reader Question:
Legibility Matters, CMS Stresses
Question: I have heard payers are cracking down on illegible provider documentation. My ... Read more
Available Years:  2013  2012  2011  2010  2009  2008  2007  2006  2005  2004  2003