Wiki 99215

[bschase]

Does anyone know of what would justify a 99215 in Ophthalmology? Blindness, macular degeneration?

Thanks for the help!

 

[slik]

Time would qualify it.

 

[Cheezum51]

I think you might be on thin ice using time for 99215.

The level 5 codes for ophthalmology are best used for sudden sight threatening problems a patient develops such as retinal detachment, sudden loss of vision, central retinal artery or vein occlusion etc.

I wouold only use the 99215 code for the initial visit when the patient presents with the problem and then use the appropriate 99xxx oe 92xxx codes for follow up visits.

Tom Cheezum, O.D., CPC

 

[avon4117]

Wouldn't the initial visit be 99201-99205?

 

[CodingKing]

In regards to time based billing I'm sure it's possible the MD/OD could spend more than 50% on counseling and care coordination but I assume it would be rare compared to other areas of medicine.

Wouldn't the initial visit be 99201-99205?

Depends if its an established patient but you are correct 99205 if new patient

 

[Cheezum51]

Since bschase asked about the 99215, I assumed this was an established patient. If a new patient, then the 99205 would be appropriate for the severe conditions I mentioned previously.

Tom Cheezum, O.D., CPC