Wiki New to ophthalmology!!!!

prabha

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Hi All,
I was in to IVR coding for more than 10 years...Now going to do, ophthalmology coding for a physician...

Iam new to this...can anyone pls share any resource or manual on ophthal coding for a begginner pls...

Also, are there any specific modifiers except the E.

Any help would be greatly appreciated...
 
Hello Prabha👀
I code opthamology. Here are some tips. Opth. CPT codes in CPT manual range from CPT 92004 to 92014, 92015, 92340, 92342 and 92352. CPT 92227 can be bundled in at times. Also CPT 67228 Panoretinal Photocoag. type of laser treatment . You can use modifier 25 if something special & additional is done in office. Your doc can use CPT 99202-CPT 99214 if treating other chronic illness if not related to eye disease or if when eye visit have been capped already for the year. Most payers will not cover prolonged CPT codes related to eye care CPT codes. If patient has used all eye visits doc can use Eva. mgt codes. If doc treating pt at hospital for eye illness bill proper setting with Eva. mgnt codes. The eye injections codes are J7028, J0178 and C9257 called IVE eye injections Ensure add modifier LT or RT to eye injections in conjunction with OD=right eye and OS -left eye and OU is both eyes with corresponding dx codes. Plus there are modifiers for eyelids too. There are diagnosis codes specific this for eye injuries or illnesses section H00-H70. DFE = Dilate Fundus Exam is CPT 92133 92134 92250
Ok here are come common Z dx codes Z01.01 ,Z01.02 Naturally there are more. Dx Z96.1 and H27.01 cannot be on same claim.
Dx Z46.02 encounter for glasses. 👓 DM II with optha.dx block code E11.311-341
There are many medical acronyms. Goggle them but here are some common ones. I ll give you ophthalmology abbreviation and dx code. It will help you learn by recognizing the abbreviations.
AMD dx H35.3 Ocular HTN H40.053 PCIOL dx H27.133
BDR dx E11.311 IOL dx Z96.1 PDR E11.3599
BRVO dx H34.839 Burry Vision H53.8 PVD H43.812
DME dx E11.311 RK H17.9 NSC H25.13
DES dx H04.12 RPE dx H35.54 👁️
EBMD dx H18.545 Numbness Eyelids Dx H02.432 MRx H52.7
ERMS eye puckering dx H53.373 HVF dx H53.40 NIDDM dx E11.329
And Pseudophakia (aka Aphakia) is H27.01

I hope this helps you 😊
Lady T
 
Last edited:
Hi All,
I was in to IVR coding for more than 10 years...Now going to do, ophthalmology coding for a physician...

Iam new to this...can anyone pls share any resource or manual on ophthal coding for a begginner pls...

Also, are there any specific modifiers except the E.

Any help would be greatly appreciated...
I sent some helpful data.
 
Hello Prabha👀
I code opthamology. Here are some tips. Opth. CPT codes in CPT manual range from CPT 92004 to 92014, 92015, 92340, 92342 and 92352. CPT 92227 can be bundled in at times. Also CPT 67228 Panoretinal Photocoag. type of laser treatment . You can use modifier 25 if something special & additional is done in office. Your doc can use CPT 99202-CPT 99214 if treating other chronic illness if not related to eye disease or if when eye visit have been capped already for the year. Most payers will not cover prolonged CPT codes related to eye care CPT codes. If patient has used all eye visits doc can use Eva. mgt codes. If doc treating pt at hospital for eye illness bill proper setting with Eva. mgnt codes. The eye injections codes are J7028, J0178 and C9257 called IVE eye injections Ensure add modifier LT or RT to eye injections in conjunction with OD=right eye and OS -left eye and OU is both eyes with corresponding dx codes. Plus there are modifiers for eyelids too. There are diagnosis codes specific this for eye injuries or illnesses section H00-H70. DFE = Dilate Fundus Exam is CPT 92133 92134 92250
Ok here are come common Z dx codes Z01.01 ,Z01.02 Naturally there are more. Dx Z96.1 and H27.01 cannot be on same claim.
Dx Z46.02 encounter for glasses. 👓 DM II with optha.dx block code E11.311-341
There are many medical acronyms. Goggle them but here are some common ones. I ll give you ophthalmology abbreviation and dx code. It will help you learn by recognizing the abbreviations.
AMD dx H35.3 Ocular HTN H40.053 PCIOL dx H27.133
BDR dx E11.311 IOL dx Z96.1 PDR E11.3599
BRVO dx H34.839 Burry Vision H53.8 PVD H43.812
DME dx E11.311 RK H17.9 NSC H25.13
DES dx H04.12 RPE dx H35.54 👁️
EBMD dx H18.545 Numbness Eyelids Dx H02.432 MRx H52.7
ERMS eye puckering dx H53.373 HVF dx H53.40 NIDDM dx E11.329
And Pseudophakia (aka Aphakia) is H27.01

I hope this helps you 😊
Lady T
Hi I have a question is this a valid diagnosis for 2024 H52.03? thank you
 
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