Optometry Coding & Billing Alert
Part I:
Get to the Basics on Diagnostic Test Coding
From refractions to EO, read on for a refresher of the general rules and guidelines for ... Read more
Get to the Basics on Diagnostic Test Coding
From refractions to EO, read on for a refresher of the general rules and guidelines for ... Read more
E/M:
Make Sure Your E/M Claims Aren't Part of the 14.6%Error Rate
NPP claims are part of the problem. Evaluation and management coding and “incide... Read more
Make Sure Your E/M Claims Aren't Part of the 14.6%Error Rate
NPP claims are part of the problem. Evaluation and management coding and “incide... Read more
Reimbursement:
This One Tip Can Boost Your Practice's Income by Thousands
Make 2016 your highest income year ever. As you close the books on your 2015 billings,... Read more
This One Tip Can Boost Your Practice's Income by Thousands
Make 2016 your highest income year ever. As you close the books on your 2015 billings,... Read more
You Be the Expert:
Corneal Pachymetry in Both Eyes
Question: I’m trying to submit a claim for 76514 performed on both eyes, but I&rsq... Read more
Corneal Pachymetry in Both Eyes
Question: I’m trying to submit a claim for 76514 performed on both eyes, but I&rsq... Read more
Reader Question:
Don't Take Chart Amendments Lightly
Question: One of our physicians made mistakes on several charts and printed out new docu... Read more
Don't Take Chart Amendments Lightly
Question: One of our physicians made mistakes on several charts and printed out new docu... Read more
Reader Question:
Pinpoint POS Codes with This Quick Guide
Question: I have heard that MACs are paying close attention to our place of service (POS... Read more
Pinpoint POS Codes with This Quick Guide
Question: I have heard that MACs are paying close attention to our place of service (POS... Read more
Diagnostics:
Single Fundus Photography Code Has Hidden Complexities
Know diagnosis coding and bilateral rules, or risk $79 each time. If your practice is ... Read more
Single Fundus Photography Code Has Hidden Complexities
Know diagnosis coding and bilateral rules, or risk $79 each time. If your practice is ... Read more
ICD-10:
Watch H54 Family for Streamlined Visual Impairment Coding
ICD-10 simplifies code set to 17 codes from 45 in ICD-9. While the enormity of making ... Read more
Watch H54 Family for Streamlined Visual Impairment Coding
ICD-10 simplifies code set to 17 codes from 45 in ICD-9. While the enormity of making ... Read more
Compliance:
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $... Read more
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $... Read more
Billing:
This MAC Offers 10 Methods to Avoid Appeals
Hint: Modifiers are your friends. If you spend a lot of your valuable time processing ... Read more
This MAC Offers 10 Methods to Avoid Appeals
Hint: Modifiers are your friends. If you spend a lot of your valuable time processing ... Read more
You Be the Expert:
Slit-Lamp-Only Exam
Question: One of our optometrists uses a slit-lamp to check on healing after a foreign-b... Read more
Slit-Lamp-Only Exam
Question: One of our optometrists uses a slit-lamp to check on healing after a foreign-b... Read more
Reader Question:
Avoid ICD-9 and ICD-10 on 1 CMS-1500 Form
Question: Our physician admitted a patient in September and didn’t discharge her u... Read more
Avoid ICD-9 and ICD-10 on 1 CMS-1500 Form
Question: Our physician admitted a patient in September and didn’t discharge her u... Read more
Reader Question:
Test EHR Functionality Frequently Post-Implementation
Question: What should our practice do to prevent unintended consequences from electronic... Read more
Test EHR Functionality Frequently Post-Implementation
Question: What should our practice do to prevent unintended consequences from electronic... Read more
Reader Question:
Specify Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requi... Read more
Specify Refraction Exclusion to Clarify ABN Confusion
Question: Are patients undergoing keratoconus workup or contact lens fitting still requi... Read more
Extended Ophthalmoscopy:
Scope Out EO Coding Guidelines, or Risk $28 Each Time
Know when you can – and can’t – report this procedure separately. Is... Read more
Scope Out EO Coding Guidelines, or Risk $28 Each Time
Know when you can – and can’t – report this procedure separately. Is... Read more
ICD-10:
Get to Know Your 30 New Options for Vitreous Disorders
The diagnosis code set expands nearly fourfold with H43 series. A... Read more
Get to Know Your 30 New Options for Vitreous Disorders
The diagnosis code set expands nearly fourfold with H43 series. A... Read more
ICD-10:
Understand Grace Period
Check out these resources, too. You’re using ICD-10, and you’re not too su... Read more
Understand Grace Period
Check out these resources, too. You’re using ICD-10, and you’re not too su... Read more
Compliance:
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $... Read more
Get Ahead of Notification Curve for PHI Breach
Avoid stiff penalties that could hurt your practice. With fines ranging from $100 to $... Read more
Electronic Health Records:
Lessons Learned From Doctors' Dissatisfaction with EHR Issues
Surprisingly, EHRs are adding to difficulties instead of reducing workload, says study. ... Read more
Lessons Learned From Doctors' Dissatisfaction with EHR Issues
Surprisingly, EHRs are adding to difficulties instead of reducing workload, says study. ... Read more
Reader Question:
Use 92285 to Track Disease Progression
Question: I’m not sure when I can and can’t bill for slit-lamp photogra... Read more
Use 92285 to Track Disease Progression
Question: I’m not sure when I can and can’t bill for slit-lamp photogra... Read more
Visual Fields:
Get Answers to Your Frequently Asked VF Questions
Facing the “two visual fields for a bleph patient” dilemma? Read on for our ... Read more
Get Answers to Your Frequently Asked VF Questions
Facing the “two visual fields for a bleph patient” dilemma? Read on for our ... Read more
ICD-10:
Seek Out H47 Series for Optic Disc Disorders
With the new diagnosis codes officially in play, say goodbye to the 377.xx ICD-9 codes. ... Read more
Seek Out H47 Series for Optic Disc Disorders
With the new diagnosis codes officially in play, say goodbye to the 377.xx ICD-9 codes. ... Read more
ICD-10:
Practices Report Mostly Smooth Sailing Through ICD-10 Transition
Some potential issues, however, may remain to be seen. If you asked medical practices ... Read more
Practices Report Mostly Smooth Sailing Through ICD-10 Transition
Some potential issues, however, may remain to be seen. If you asked medical practices ... Read more
You Be the Expert:
68761 With E/M
Question: When my optometrist does a comprehensive exam (92004) and decides to inse... Read more
68761 With E/M
Question: When my optometrist does a comprehensive exam (92004) and decides to inse... Read more
Reader Question:
Avoid EO Denials With Proper 92225-92226 Use
Question: I just got a denial on 92226. I think I might be using this code incorrec... Read more
Avoid EO Denials With Proper 92225-92226 Use
Question: I just got a denial on 92226. I think I might be using this code incorrec... Read more
Reader Question:
Obey the 60-day Max for Locum Tenens
Question: We will employ a substitute physician to fill in for one of our optometri... Read more
Obey the 60-day Max for Locum Tenens
Question: We will employ a substitute physician to fill in for one of our optometri... Read more
Reader Question:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a direct... Read more
Contact Lenses:
Contact Coding Story Doesn't Stop at 92310
Get your deserved reimbursement for medically necessary lenses. Seasoned optometry cod... Read more
Contact Coding Story Doesn't Stop at 92310
Get your deserved reimbursement for medically necessary lenses. Seasoned optometry cod... Read more
More Changes Coming for Visual Disturbances Dx
H53 family also covers visual field defects, color vision deficiency, and night blindnes... Read more
H53 family also covers visual field defects, color vision deficiency, and night blindnes... Read more
ICD-10:
CMS Reps: All Systems Go for Next Month's ICD-10 Launch
You can continue to participate in acknowledgement testing until Oct. 1. You’ve ... Read more
CMS Reps: All Systems Go for Next Month's ICD-10 Launch
You can continue to participate in acknowledgement testing until Oct. 1. You’ve ... Read more
Compliance:
CMS: Improper E/M Coding Remains a Growing Problem
Part B error rate is worse this year than last. No matter where you look, you’re... Read more
CMS: Improper E/M Coding Remains a Growing Problem
Part B error rate is worse this year than last. No matter where you look, you’re... Read more
You Be the Expert:
Multiple FBs
Question: How should I report the encounter when the optometrist removes a pair of ... Read more
Multiple FBs
Question: How should I report the encounter when the optometrist removes a pair of ... Read more
Reader Question:
Eye G0117 or G0118 for Glaucoma Screenings
Question: A Medicare patient presented for a glaucoma screening. He had no personal... Read more
Eye G0117 or G0118 for Glaucoma Screenings
Question: A Medicare patient presented for a glaucoma screening. He had no personal... Read more
Reader Question:
'No Charge' Visits Still Count Toward Established Patient Status
Question: Our optometrist saw a patient during a quick assessment last year at no c... Read more
'No Charge' Visits Still Count Toward Established Patient Status
Question: Our optometrist saw a patient during a quick assessment last year at no c... Read more
Testing:
Scan Your 76519 and 92136 Coding for These Destructive Myths
Tip: Knowing the bilateral rules for the technical and professional portions is critical... Read more
Scan Your 76519 and 92136 Coding for These Destructive Myths
Tip: Knowing the bilateral rules for the technical and professional portions is critical... Read more
ICD-10:
Check These Visual Disturbances Dx Changes
Tip: Some codes ranges have been expanded to show laterality. Like many of the current... Read more
Check These Visual Disturbances Dx Changes
Tip: Some codes ranges have been expanded to show laterality. Like many of the current... Read more
Office Visits:
Here's How to Make the E/M vs. Eye Codes Choice Simple
You’ve got two options for coding office visits – here’s how to decide... Read more
Here's How to Make the E/M vs. Eye Codes Choice Simple
You’ve got two options for coding office visits – here’s how to decide... Read more
Eye Code or E/M Code?
Consult this guide before picking a code for your next office visit. E/M Codes: ... Read more
Consult this guide before picking a code for your next office visit. E/M Codes: ... Read more
You Be the Expert:
Routine Exam for Keratoconus Patient
Question: How should I bill for a routine exam with the diagnosis post-keratoplasty... Read more
Routine Exam for Keratoconus Patient
Question: How should I bill for a routine exam with the diagnosis post-keratoplasty... Read more
Reader Questions:
Know Documentation Requirements for Provocative Glaucoma Tests
Question: What testing and documentation do I need to bill for 92140 (Provocative t... Read more
Know Documentation Requirements for Provocative Glaucoma Tests
Question: What testing and documentation do I need to bill for 92140 (Provocative t... Read more
AMD:
Know the Specifics for Wet or Dry AMD Coding
Optometrists have a crucial role in the care of age-related macular degeneration patient... Read more
Know the Specifics for Wet or Dry AMD Coding
Optometrists have a crucial role in the care of age-related macular degeneration patient... Read more
ICD-10:
H40.6 Family Holds Key to Corticosteroid-Induced Glaucoma
Tip: Each character in the ICD-10 code tells you something specific about the condition.... Read more
H40.6 Family Holds Key to Corticosteroid-Induced Glaucoma
Tip: Each character in the ICD-10 code tells you something specific about the condition.... Read more
You Be the Expert:
Proliferative Diabetic Retinopathy
Question: Our optometrist diagnosed a patient with proliferative diabetic retinopat... Read more
Proliferative Diabetic Retinopathy
Question: Our optometrist diagnosed a patient with proliferative diabetic retinopat... Read more
ICD-10:
5 FAQs Quell Confusion on CMS's Latest ICD-10 Announcement
The one- year grace period for ICD-10 claims applies to Medicare only. If CMS’s ... Read more
5 FAQs Quell Confusion on CMS's Latest ICD-10 Announcement
The one- year grace period for ICD-10 claims applies to Medicare only. If CMS’s ... Read more
Reader Questions:
92134, 92250 Help Track Glaucoma and DR Progress
Question: The optometrist is monitoring a patient who has glaucoma and diabetic ret... Read more
92134, 92250 Help Track Glaucoma and DR Progress
Question: The optometrist is monitoring a patient who has glaucoma and diabetic ret... Read more
Reader Questions:
ICD-10 Specificity Won't Make Modifiers Obsolete
Question: I have heard the ICD-10 codes are expanded and more specific than ICD-9 c... Read more
ICD-10 Specificity Won't Make Modifiers Obsolete
Question: I have heard the ICD-10 codes are expanded and more specific than ICD-9 c... Read more
Reader Questions:
Choosing New vs. Established Patient Codes
Question: What is the difference between a new and established patient, for office E/M c... Read more
Choosing New vs. Established Patient Codes
Question: What is the difference between a new and established patient, for office E/M c... Read more
Gonioscopy:
Coding 92020 Bilaterally? Read This First
Frequently asked questions about a frequently performed procedure. Gonioscopy may not ... Read more
Coding 92020 Bilaterally? Read This First
Frequently asked questions about a frequently performed procedure. Gonioscopy may not ... Read more
ICD-10:
Close In on New Dx Codes for Primary Angle-Closure Glaucoma
Hint: Know the significance of each character to identify most accurate code. In ICD-1... Read more
Close In on New Dx Codes for Primary Angle-Closure Glaucoma
Hint: Know the significance of each character to identify most accurate code. In ICD-1... Read more
Compliance:
MACs to Start Eyeing Your POS Line Items
Place of service errors cost CMS over $33 million. The OIG’s 2015 Work Plan indi... Read more
MACs to Start Eyeing Your POS Line Items
Place of service errors cost CMS over $33 million. The OIG’s 2015 Work Plan indi... Read more
Use This Quick Guide to Pinpoint POS Codes
If you think you might be at risk of making place of service (POS) errors like the OIG f... Read more
If you think you might be at risk of making place of service (POS) errors like the OIG f... Read more
You Be the Expert:
Multiple FBRs
Question: A patient reported with a foreign-body sensation after mowing the lawn an... Read more
Multiple FBRs
Question: A patient reported with a foreign-body sensation after mowing the lawn an... Read more
Reader Questions:
Read This Before Billing Separately for EO
Question: A patient reports flashes and floaters but the optometrist does not find ... Read more
Read This Before Billing Separately for EO
Question: A patient reports flashes and floaters but the optometrist does not find ... Read more
Reader Questions:
Expect Record Review to Be Part of Office Visit
Question: A patient had 10 years of medical records sent to our physician for revie... Read more
Expect Record Review to Be Part of Office Visit
Question: A patient had 10 years of medical records sent to our physician for revie... Read more
Diagnostic Tests:
Follow These 4 Tips for SCODI Coding Success
Documentation, modifiers, and knowing your bundling rules can be worth nearly $45 each t... Read more
Follow These 4 Tips for SCODI Coding Success
Documentation, modifiers, and knowing your bundling rules can be worth nearly $45 each t... Read more
ICD-10:
Look Sharp: Oct. 1 Will Bring Changes to Your Open-Angle Glaucoma Coding
Tip: Seventh digit will describe glaucoma stage; sixth digit may designate an eye. Whe... Read more
Look Sharp: Oct. 1 Will Bring Changes to Your Open-Angle Glaucoma Coding
Tip: Seventh digit will describe glaucoma stage; sixth digit may designate an eye. Whe... Read more
ICD-10:
Final Countdown: Take 6 Steps to Prepare for October ICD-10 Transition
Tip: Try ‘dual coding’ to exercise your ICD-10 abilities. With no further ... Read more
Final Countdown: Take 6 Steps to Prepare for October ICD-10 Transition
Tip: Try ‘dual coding’ to exercise your ICD-10 abilities. With no further ... Read more
Medicare Pay:
Usher Out SGR Formula - For Good
Expect new quality pay plan(s). You won’t ever have to cross your fingers again ... Read more
Usher Out SGR Formula - For Good
Expect new quality pay plan(s). You won’t ever have to cross your fingers again ... Read more
You Be the Expert:
VF & Temp Plugs
Question: A patient came in for visual field (VF) tests. During the same visit, the... Read more
VF & Temp Plugs
Question: A patient came in for visual field (VF) tests. During the same visit, the... Read more
Reader Question:
Dx Determines 76514 Frequency
Question: How often in a year can a patient have pachymetry done? Is this a once only in... Read more
Dx Determines 76514 Frequency
Question: How often in a year can a patient have pachymetry done? Is this a once only in... Read more
Cataracts:
Are These Myths Holding Back Your Cataract Post-Op Care Claims?
Tip: Communication with the surgeon is key to getting your deserved reimbursement. By ... Read more
Are These Myths Holding Back Your Cataract Post-Op Care Claims?
Tip: Communication with the surgeon is key to getting your deserved reimbursement. By ... Read more
ICD-10:
Explore H44 for More Disorders of the Globe Dx
Degenerative myopia, siderosis diagnoses will specify affected eye. In our last issue,... Read more
Explore H44 for More Disorders of the Globe Dx
Degenerative myopia, siderosis diagnoses will specify affected eye. In our last issue,... Read more
ICD-10:
Sign Up Now to Test Your Practice's ICD-10 Readiness
Determine which testing option is best for your providers. You don’t want to be ... Read more
Sign Up Now to Test Your Practice's ICD-10 Readiness
Determine which testing option is best for your providers. You don’t want to be ... Read more
Billing:
These 6 Tips Will Transform Your Accounts Receivables
Coordinate back office and front desk staff to keep cash flow positive. You know you&r... Read more
These 6 Tips Will Transform Your Accounts Receivables
Coordinate back office and front desk staff to keep cash flow positive. You know you&r... Read more
You Be the Expert:
Fundus Photos for Diabetic Patient
Question: If you perform 92250 (Fundus photography) on a patient with diabetes and ... Read more
Fundus Photos for Diabetic Patient
Question: If you perform 92250 (Fundus photography) on a patient with diabetes and ... Read more
Reader Questions:
Focus on Payer Rules Governing 51 Use
Question: I have heard our coders saying that they don’t need to attach modi... Read more
Focus on Payer Rules Governing 51 Use
Question: I have heard our coders saying that they don’t need to attach modi... Read more
Reader Questions:
Heed Insurer Preference on New Patients
Question: If a provider of a different specialty within the same group sees the same pat... Read more
Heed Insurer Preference on New Patients
Question: If a provider of a different specialty within the same group sees the same pat... Read more
Diagnostic tests:
Make Sure Your EO Claims Stand Up to Audits
Review this FAQ and get to know some of the common extended ophthalmoscopy tripping poin... Read more
Make Sure Your EO Claims Stand Up to Audits
Review this FAQ and get to know some of the common extended ophthalmoscopy tripping poin... Read more
ICD-10:
Zoom In on H44 Codes for Endophthalmitis, Other Disorders of Globe
New diagnosis codes break condition down by left, right, both or unspecified eyes. Whe... Read more
Zoom In on H44 Codes for Endophthalmitis, Other Disorders of Globe
New diagnosis codes break condition down by left, right, both or unspecified eyes. Whe... Read more
Compliance:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20... Read more
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20... Read more
E/M Coding:
3 Ways Comparative Billing Reports Can Rescue Your Coding
Use the CBRs as springboards to gauge your accuracy. Your MACs are reviewing the most ... Read more
3 Ways Comparative Billing Reports Can Rescue Your Coding
Use the CBRs as springboards to gauge your accuracy. Your MACs are reviewing the most ... Read more
You Be the Expert:
Bifocal and Trifocal Segments
Question: I’m really confused about codes V2219 and V2319 for Medicare patients. I... Read more
Bifocal and Trifocal Segments
Question: I’m really confused about codes V2219 and V2319 for Medicare patients. I... Read more
Reader Question:
Don't Fear ICD-10 Transition
Question: I’ve been told that ICD-10 will be nearly impossible to use because... Read more
Don't Fear ICD-10 Transition
Question: I’ve been told that ICD-10 will be nearly impossible to use because... Read more
Visual Fields:
Don't Let These VF Myths Narrow Your Reimbursement Field
Are you regularly coding 92082 when you could justifiably code 92083? You’re not a... Read more
Don't Let These VF Myths Narrow Your Reimbursement Field
Are you regularly coding 92082 when you could justifiably code 92083? You’re not a... Read more
ICD-10:
Q10.- Has Your Congenital Eyelid Malformations Dx Answers
Get ready: Implementation date is still set for this October. Unlike many of the ICD-1... Read more
Q10.- Has Your Congenital Eyelid Malformations Dx Answers
Get ready: Implementation date is still set for this October. Unlike many of the ICD-1... Read more
Medicare Errors:
Let CERT Findings Focus E/M Claims
Avoid key documentation mistakes that cost you pay. Imagine if you lost 10 perce... Read more
Let CERT Findings Focus E/M Claims
Avoid key documentation mistakes that cost you pay. Imagine if you lost 10 perce... Read more
Billing:
Get the Lowdown on What to Look for During Successful Payer Contract Negotiations
Pay attention to eight key points in the fine print. While contracts don’t have ... Read more
Get the Lowdown on What to Look for During Successful Payer Contract Negotiations
Pay attention to eight key points in the fine print. While contracts don’t have ... Read more
You Be the Expert:
Refraction Services
Question: For refraction, should I report a 992xx or 92xxx exam code? Mai... Read more
Refraction Services
Question: For refraction, should I report a 992xx or 92xxx exam code? Mai... Read more
Reader Question:
Add to Your ICD-10 Know-How
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes and E... Read more
Add to Your ICD-10 Know-How
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes and E... Read more
Reader Question:
Clear Up Patient Medicare Confusion
Question: We have a patient asking why she has to pay anything when we accept assignment... Read more
Clear Up Patient Medicare Confusion
Question: We have a patient asking why she has to pay anything when we accept assignment... Read more