Wiki 92066 = loss of $$$

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Plaw4444

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Gold Canyon, AZ
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Which will actually PAY and prevent significant loss of revenue (won't put us out of business):
  • 92066 + 92499 + 92499? pt winding up responsible (and angry?) or:
  • 2 units of “97” codes under an OT License and +92066 under Ophth. license or:
  • Bill 2 units of “97” codes+92066 under Ophth. license or:
  • Bill 92066 but slowly drop insurance carriers and become cash pay (angry pts again?) Respectfully, DW CPMA, COPC, CPC
 
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Your revenue for these various codes is going to depend on your contracts and the payer mix of your patient population, and without knowing that information, it's really impossible to help you with this. In addition, 92499 is an unlisted code that doesn't have a set fee and for which the reimbursement is going to depend on what service you're performing and what each payer ultimately determines it is worth. You haven't described what service it is that warrants an unlisted code, so I wouldn't even know where to start with that.

But the codes you bill are going to be determined by the services performed and not by how much you get paid or what makes the patient happy. You have to choose your choosing according to guidelines based on what the provider has documented performing. You don't really have the option of billing different codes in order to try to get better payment rates or to avoid making patients angry.

FYI, please don't make multiple duplicate posts of your question at the same time, this is against the forum rules.
 
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