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Optometry Coding & Billing Alert
Optometry Coding & Billing Alert
Optometry Coding & Billing Alert - 2014; Volume 12, Number 12
Testing:
Don't Let Unanswered IOL Power Calculation Questions Cloud Your Reimbursement
Read on for our expert answers to these 76519 and 92136 head-scratchers. Calculating i...
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Reimbursement:
Final Fee Schedule Confirms Phasing Out of Global Periods
Some practices should prepare for a 2 percent cut to Medicare payments. When CMS annou...
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Billing:
Step Up Your Benefits Verification for the New Year
Don’t leave eligibility checks to the last minute or you’ll face non-payment...
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ICD-10:
Keep Your Eye on Revised Retinal Detachment Diagnosis Codes
Substitute these H33.--- codes for the 361.xx ICD-9 codes. As with many of the diagnos...
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You Be the Expert:
Exophthalmometry
Question: Is there a CPT code for exophthalmometry? New York Subscriber Answ...
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Reader Question:
Try Modifier 52 for Unilateral OCT
Question: We performed an OCT on a patient’s left eye, and filed the claim wi...
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Reader Question:
Don't Bill Patient for Records Transfer
Question: Our practice discharged a patient due to non-payment, and one week later ...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 11
Extended Ophthalmoscopy:
Routine or Extended? Initial or Subsequent? Find Your EO Answers Here
Tip: Be sure to understand bilateral rules before you file your next claim. For ...
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ICD-10:
Look to H10 Series for Conjunctivitis in 2015
Hint: In many cases, an additional digit will specify which eye is infected. When ICD-...
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Documentation:
New MAC Tip Reminds Practices What Ancillary Staff Can -- and Cannot -- Document
Documenting HPI is the job of the doctor or NPP. Your ancillary staff might be quite a...
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Billing:
Get Comfortable with Unruly Consolidated Billing Rules
Uncover who, what, and when to bill so you get your money. Knowing whether your skille...
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Correction
The answer to the “You Be the Expert” question in the Optometry Coding &...
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You Be the Expert:
Dry Eye Diagnosis
Question: Can 375.15 and 370.21 be used interchangeably? When would one be the pref...
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Reader Question:
Consider Including Telephone E/M in History or MDM
Question: We have a new patient that called his proivder to discuss his visit that ...
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Reader Question:
Determine POS Before Checking RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 10
DME Reimbursement:
Are These Refractive Lens Myths Keeping Payment Out of Your Pocket?
Tip: Keep modifiers KX, EY, GA in your toolbox. Optometrists across the country agree:...
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ICD-10:
Get to Know the New Senile Cataract Codes
In 2015, your diagnosis coding will specify condition as well as which eye is affected. ...
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Modifier Review:
Brace Yourself with Modifier 59 for Distinct Procedural Services
Refer to Medicare’s Correct Coding Initiative (CCI) before using Modifier 59 Mod...
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Patient Privacy:
Avoid Brutal HIPAA Fines With These 3 Steps
Take HITECH lessons to heart and protect your bottom line. They might look like ...
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You Be the Expert:
Extended Ophthalmoscopy
Question: I just got a denial on 92226. I think I might be using this code incorrec...
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Reader Question:
Single Code's the Key for Multiple FBs
Question: How should I report the encounter when the optometrist removes a pair of ...
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Reader Question:
What's the Big ICD-10 Picture?
Question: I appreciate the monthly ICD-10 example in your newsletter, but I don&rsq...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 9
Coding Quiz:
Test Your VF Knowledge With These 92081-92083 Head-Scratchers
Then read on to see how your visual field coding and billing expertise stacks up. Visu...
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Compliance:
Watch Out For Sophisticated Malware Breaching Your Systems From Overseas
Pay attention: Massive breach teaches you four crucial lessons. The latest HIPAA breac...
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ICD-10:
Zero In on Specific Eyelid
The new set of diagnostic codes greatly expands on ICD-9’s “Other disorders ...
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Coding Quiz Answers:
Test Your Visual Field Knowledge
Hint: Unilateral or bilateral — it’s all the same to your payers. The ques...
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You Be the Expert:
Nonconclusive HRT
Question: How should I code for a nonconclusive HRT? One of our patients had one do...
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Reader Question:
Bring In ABN Benefits
Question: Should I bill Medicare for services that I know they’ll deny based ...
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Reader Question:
Appeal Is an Option When Patient Prevents Timely Filing
Question: We have a timely filing concern. Our physician saw a patient who didn&rsq...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 8
Contact Lenses:
5 FAQs to Sharpen Your Contact Lens Coding
Tip: It matters whether an optometrist or a technician provides the prescription and fit...
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ICD-10:
Know the New Dx Options for Diabetes With Ophthalmic Manifestations
In some cases, one code will do where you once needed two. The countdown is on: You no...
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ICD-10:
These 3 ICD-10 Answers May Surprise You
Hint: Forget everything you know about ICD-9’s ‘excludes’ codes after ...
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Chart Auditing:
Boost Your Confidence with Chart Sampling
Which of the three sampling methods will work best for your practice? You know that pe...
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You Be the Expert:
Low-Risk Glaucoma Screenings
Question: Our office sometimes performs glaucoma screenings for patients who don&rs...
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Reader Question:
Keep Modifier TC in Your 92081-92083 Toolbox
Question: We performed a visual field ordered by a doctor outside our practice. The pati...
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Reader Question:
Tackle UB-04 vs. CMS-1500 Dilemma
Question: I used to bill for a facility and am new to the role of practice manager ...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 7
Fundus Photos:
Check These Fundus FAQs to Keep Your Coding Straight
Do you know what to do if the optometrist only tests unilaterally? t’s a sign of...
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ICD-10:
Diagnostic Options Expand for Borderline Glaucoma
In 2015, your Dx code will have to specify which eye is affected. As you read elsewher...
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Modifiers:
CMS Debuts 4 New Modifiers to Substitute for 59
Medicare will still accept modifier 59, but use the new modifiers instead when applicabl...
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Documentation:
Avoid Faltering on Signature Rules & Exceptions With These 3
Useful Tips Analyze CMS’s requirements or you risk the wrong use of signatures. ...
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Reader questions:
Turn to Unlisted E/M If Visit Doesn't Match Key Element Requirements
Question: Can I use modifier 52 on 99201 if my provider only captures history and M...
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You Be the Expert:
Drug Effect Exam
Question: Which diagnosis code should I use to report visual field tests to evaluat...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 6
Gonioscopy:
Are These 92020 Myths Holding Back Your Reimbursement?
Get ready to learn the truth behind postoperative tests, bilateral billing, and more. ...
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ICD-10:
Report Glaucoma Type, Location, Stage All With 1 Code
In 2015, you’ll no longer need to report an additional Dx code to indicate glaucom...
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Part B Payment:
Proposed Fee Schedule Suggests Major Global Period Changes
Optometrists may see little impact, but other specialties’ reimbursement could ris...
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Modifier 25:
Major Payer Changes Modifier 25 Policy
You’ll need a new diagnosis for E/M payment from Tufts. Most optometry practices...
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News You Can Use:
See How CMS Addresses ICD-10 Delay
Users question ICD-9, too. You know that Congress instituted an ICD-10 delay, but do y...
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You Be the Expert:
Foreign Body Removal
Question: Can we code 65205 or 65220 if we used a cotton swab to remove a foreign b...
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Reader Question:
Use Caution With Write Offs
Question: At what point can we write off a patient balance as bad debt? Are there c...
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Reader Question:
Watch for Payer Differences With Claim Forms
Question: I need some help concerning the rules for billing on the new CMS-1500 for...
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Reader Question:
Don't Get Too Comfortable With Blanket ABNs
Question: I recently started working at a practice that I think overuses ABNs. Can we as...
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Reader Question:
Learn The Method to Determine Reimbursement Using RVUs
Question: Using the RVUs provided for a particular code, how do I arrive at the app...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 5
Coding Quiz:
Get Plugged In to Punctal Plug Reimbursement
Try your hand at the below questions, then read on for our expert answers. Between the...
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Coding Quiz Answers:
Shed No More Tears Over Punctal Plug Reimbursement
How do your answers compare with our experts’? Read on for the answers to the pu...
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ICD-10:
New Eye Irritation Diagnosis Codes Get Specific
Conjunctivitis, blepharitis and dry eye codes expand options starting October 2015. Wi...
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Compliance:
OIG Considers Expanding Civil Monetary Penalties
You could be subject to penalties for five additional reasons if the proposal is finaliz...
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News You Can Use:
CMS Answers ICD-10 Questions -- By Not Answering
Representatives stay mum about the details of the delay. The recent delay of ICD-10 un...
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HIPAA:
Let This Example Show You What Not to Do With Your BAs
Warning: You can be responsible for your BA’s violations. Your practice has a so...
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Reader Question:
Focus on 'Incident-to' Rules
Question: The following scenario occurred in our practice: Physician A covered an e...
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Reader Question:
Tackle UB-04 vs. CMS-1500 Dilemma
Question: I used to bill for a facility and am new to the role of practice manager ...
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You Be the Coder:
Non-Serial Tonometry
Question: Our optometrist renders single-episode tonometry services on her patients...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 4
FAQ:
Tackle These Exam-Without-Dilation Coding Scenarios
It’s a thorny coding dilemma, but savvy coders know the solution. A dilation is ...
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Advance Beneficiary Notices:
Know These 4 Categories of Noncovered Services
Sometimes it can be hard to determine what’s considered ‘noncovered.’ ...
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ICD-10:
Make the Most of the ICD-10 Extension With These Quick Tips
New implementation date is set for Oct. 1, 2015, so be ready. Whether you’re che...
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Payer Participation:
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 complica...
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Reader Question:
Assess Risk on a Regular Basis
Question: We are having a bit of a debate in our practice. Some of us think that pe...
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Reader Question:
Slow Patient Won't Justify Timely Filing Exception
Question: Our patient gave us her Medicare card but said Medicare was her secondary...
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You Be the Coder:
Long-Standing Strabismus
Question: Another ophthalmologist referred a new patient with long-standing strabis...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 3
CCI Update:
Watch for New Visual Function Screening Bundles
Tip: Check modifier indicators for ability to report codes separately. If your practic...
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News You Can Use:
Congress Votes to Halt Your Pay Cuts and Delay ICD-10
Physician associations still plan to pursue a permanent SGR formula revision. Th...
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Documentation:
Adopt 7 Documentation Best Practices for Compliant and Complete Records
While the provider captures notes just once, they may be reviewed countless times. Whe...
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Modifiers:
Master Modifier 25 Following These Expert Tips
Haphazardly using 25 on all claims will lead to payer scrutiny. With payers cracking d...
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Reader Question:
368.8 Takes Secondary Place to Specific Diagnosis
Question: Many of our patients claim general reasons for their visit, such as &ldqu...
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Reader Question:
Consider a Flexible No-Show Policy
Question: During the snow storm last month, we had several patients call in and say...
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You Be the Coder:
FBR Follow-Up With Slit Lamp
Question: One of our optometrist uses a slit-lamp to check on healing after a forei...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 2
Diagnosis Coding Quiz:
Coding 250.00 for Patients With Ophthalmic Manifestations? Read This First
Test your knowledge of ophthalmic manifestations. With nearly 26 million Americans suf...
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ICD-10 Bridge
When ICD-10 comes into effect later this year, the ICD-9 codes in this article will no l...
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Diagnostic Tests:
Extended Ophthalmoscopy Claims Depend on Documentation, Proper Bilateral Billing
Tip: Don’t assume both eyes have the same diagnosis. Coding experts agree that e...
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ICD-10:
This Part B Payer Answers 10 Pressing ICD-10 Questions
Should you buy your book now or wait? These answers may guide you. As ICD-10 approache...
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ICD-10:
This Part B Payer Answers 10 Pressing ICD-10 Questions
Should you buy your book now or wait? These answers may guide you. As ICD-10 approache...
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Reader Question:
Incomplete Claims Equal Denials
Question: Our practice has a few claims that have missing or incorrect information....
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You Be the Coder:
Unrelated Fundus Photos
Question: We have a patient still in the global postoperative period for cataract s...
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Optometry Coding & Billing Alert - 2014; Volume 12, Number 1
Extended Ophthalmoscopy:
4 Tips Help You Scope Out Clean 92225-92226 Claims
4 Tips Help You Scope Out Clean 92225-92226 Claims Remember: Documentation and proper ...
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Compliance:
Focus on 5 Areas for Improvement in Your Provider Documentation
While EMRs improve legibility, they may lead to other issues. When your practice faces...
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Part B Payment:
Congress Offers 3-Month Reprieve on Conversion Factor Cuts
Plus: Government moves toward possible SGR repeal. If you weren’t looking forwar...
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You Be the Expert:
Gonioscopies With Photos
Question: Our optometrist saw a glaucoma patient and performed a gonioscopy. The optomet...
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E/M Coding:
Follow The 3-Year Rule To Determine Patient Status
Hint: The place of service (POS) won’t influence your choice. The first step to ...
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Reader Question:
Append GY to Refraction Claims
Question: A doctor recently told me that appending modifier GY to the refraction code wo...
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Reader Question:
POS Determines Supply Reimbursement
Question: My doctors are concerned that our practice is losing money on supplies, such a...
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