Wiki retinal drawing rules

[PattyGreen]

New coder needs help---What are specific rules for billing subsequent retinal drawings (92226)? Please send any resource info for learning ins and outs/dos and don't for all outpatient Ophthalmology codes. There doesn't seem to be much available except Coding Coach which I have but doesn't explicitly outline rules to make me comfortable I am coding correctly. Thank you for any help!!!!

 

[dkeown]

New coder needs help---What are specific rules for billing subsequent retinal drawings (92226)? Please send any resource info for learning ins and outs/dos and don't for all outpatient Ophthalmology codes. There doesn't seem to be much available except Coding Coach which I have but doesn't explicitly outline rules to make me comfortable I am coding correctly. Thank you for any help!!!!

I reference Ingenix's Coding Companion for Ophthalmology (current edition) in addition to the Ophthalmic Coding Series Modules from AAO/AAOE. Both define what makes up a service as well as what is necessary to report and bill.

Hope this helps!
David Keown, CPC, OCS

 

[mjb5019]

Go to your Medicare website and check the local coverage determinations for the CPT code and the NCCI edits and Medically unlikely edits for the CPT code which will tell you how many units and whether or not anything bundles with the CPT code and if it can be unbundled.