Plaw4444

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It was brought to my attention that medical evaluation and management CPT Codes (9920* - 9921*) reported by our Optometrists and Ophthalmologists could be rejected by CMS when billed in a SNF-Skilled Nursing Facility-setting (POS 31, 32, etc.).


I have read conflicting info indicating Optometry can bill for either a Medical Exam performed, or the 92*** for Routine (based on high-risk category or cataract SX w/IOL). Now, some of my reading does indicate the 92*** being used for both E&M type services... however that is not how we have handled our routine vs. medical.


1) Are there any carve-outs or rules as to an optometrist providing services within a SNF setting: 2) Can we bill with the correct POS code (31 or 32) and a CPT Code (992**) if medical?


Please don't pass this one by and give this one a look, okay?👀
 
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