Optometry Coding & Billing Alert
Medicare Makes Face-to-Face a Must on Consult
Question: What is the best way to code for a family consult when the patient is not present (no face-to-face contact)? The patient is a nursing home patient whom our optometrist saw, and the family wants to come in to discuss the best care. South Carolina Subscriber Answer: If this is a Medicare patient, you won- be able to charge for the consultation. Medicare only pays when the patient is present, and you won't find a way around this. You can bill the family for the visit, or you can have the family present at the nursing home with the patient in the room when the physician performs the consult. This would not be a coding "consultation" but rather a nursing home visit (99334-99337). The important thing in this situation is that the physician has face-to-face contact and evaluates the patient along with discussing treatment options with the patient's family.
Optometry Coding & Billing Alert
- Check Method, Location for Correct Coding on Eye FBRs
Doctors might need slit lamp on some corneal FBRs Coding for an ocular foreign-body removal [...] - Answer 'Separate' or 'Inherent' Question Before You Use Modifier 25
When an optometrist performs an E/M service and a procedure on the same patient during [...] - You Be the Expert:
Diagnosis Coding for Damaged Ducts
Question: I am having trouble finding the proper diagnosis code for this claim. The optometrist [...] - Follow Locum Tenens Rules for Sub Doctors
Modifier Q6 a must for substitutes When one of your optometrists takes a leave of [...] - Billing Question:
New OD Doesn't Mean New Patient
Question: We have a new optometrist in our group whose patients from his previous group [...] - Reader Questions:
Find Medical Problem in Patient's Good Eye
Question: A patient with one good eye and one prosthetic eye came in for a [...] - Reader Questions:
Blepharitis Type Drives Diagnosis Coding
Question: What is the proper ICD-9 code for patients with blepharitis? Tennessee Subscriber Answer: It [...] - Reader Questions:
Count on Full Pay per Eye for 92235
Question: Can I report 92235 times two, bilateral eyes for each visit? California Subscriber Answer: [...] - Reader Questions:
Find 'Track or Treat' Evidence for 92285 Claims - Reader Questions:
Coding Observations? Forget About Location
Question: Our optometrist performed an observation service on a patient who was not in the [...] - Reader Questions:
Modifier 76 Can Help You Avoid Repeat Denials
Question: How should I report a service that the optometrist performs more than once in [...] - Reader Questions:
Medicare Makes Face-to-Face a Must on Consult
Question: What is the best way to code for a family consult when the patient [...] - Reader Questions:
Check Column T for Bilateral Answers
Question: Our optometrist performed fundus photography on both eyes for a Medicare patient. We reported [...]
