Wiki adjustments and fittings??

[melonie_lockard@yahoo.com]

Hi,

I just have a question about adjustments and fittings. There is some confusion in my office. When a patient comes in to pickup their glasses/contacts can they bill a 99211 with dx code V53.1 for the adjustment and fitting that they do at the time? Any help would be appreciated.

Thanks

 

[annawade13]

I would say that it depends on payer guidelines, and other charges already captured, but is most likely not billable. Most vision payers state in their contracts that glasses dispense, including adjustment and fitting, is included in the reimbursement of the glasses themselves. Similarly, contact lens dispense should have already been captured in the initial contact lens fitting/evaluation charge. Not only that, many vision payers don't recognize 99xxx codes to begin with. I haven't tried with medical insurances, but you would just want to be careful that you are not charging them something you are not charging private pay patients, and vice versa.

To be certain, I would read the contracts and even contact each payer you intend to bill before doing so. And of course, if you do attempt billing, the documentation must support the codes!

Hope this helps.

 

[melonie_lockard@yahoo.com]

That helps alot. I always thought it was included, but the office where I work said they are billable. I wanted some proof that they are included.

Thank you for your help.