Wiki Ophthalmology Coding Help?

[mghughes]

Hi! I am gaining a new ophthalmology provider's account, and am relatively new to this specialty. I am of course doing my own research and such, but if anyone here has any expertise to share as I start this new practice, I would love the assistance!

Thank you all

 

[TThivierge]

Hi MG Hughes
Yup I do ophthalmology coding at times. The eye office visit are codes from 92004-92014 92015 92014 92012 9227 92340 92342. CPT 92227 bundled with 92004 92014 92012in established vs new patients. If patient gets injections in eyeballs use LT and RT modifier on claims. When reading med record notes it will give OU-both eyes, OD- right eye and OS left eye and most of dx code have these details of laterality. Orbit eye injections CPT 92014 meds J7028, J0178, & C9257. Some payers will let you use consult CPT codes if pt referred there. Add referring doc to claim. Prolonged CPT codes for eye visits are not used from my knowledge with this specialty but check with payer.
Here are some common Z codes...
Z96.01 cannot bill with dx H27.01
Z46.0 encounter for fitting glasses
Z01.01 Abnormal vision encounter
Z01.00 Vision encounter exam is normal
Presence of Artificial eye Z97.0
Aftercare eye surgery Z48.810
Adjusting visual implants Z45.31
Family HO of Glaucoma Z82.11
I suggest get list of common ophthalmology acronyms...used a lot in provider's documentation. I will give you a list of common dx codes used. I hope this helps you somewhat till get use to reading the documentation. Good luck!
Lady T.

 

[TThivierge]

Hi MG Hughes
Here are common diseases but of course you do have your ICD10 manual & can Goggle. These are the dx that I had to research a bit. Puckering eyeballs=ERMS dx H53.373 , Eyelids is Blephar. dx H01.001 Dry eye H04.12 Eye floaters dx H53.8 HVF Humphery Vision Field -dx H53.40. Pseudophakia is aka Aphakia or dxH27.01 Do not forget diabetes can cause eye problems so look at E11.32 DM block. Retinal Hypertension is dx H40.053 Refractional Error H52.7 Choroid Nevus in Eye dxH02.719 Cataracts H25 Glaucoma H40 POAG (Primary Open Angle Glaucoma is dx H40.1130) .That is a few common dx and CPT to help you. Also some of these diseases have 7th characters according to level of eye disease too. See dx block of H40 to H35.
Well hope helped you a little bit more.
Lady T