You Be the Coder: Exophthalmometry (December 2011)
Question: Is there a CPT® code for exophthalmometry?Georgia SubscriberAnswer: CPT® considers exophthalmometry – a test to measure proptosis, using a Hertel exophthalmometer – to be an integral part of the E/M service. You would not receive reimbursement for this procedure, and no CPT® code exists for separate billing of this service. If you’re using the eye codes rather than E/M codes, CPT® considers exophthalmometry included in an intermediate eye exam. When you bill an office visit to [...]
Reader Question: 66821 Works Again for Repeat YAG Capsulotomy (December 2011)
Question: The doctor performed a YAG laser capsulotomy. Six months later, during a return visit, the patient noted glare, light sensitivity, and decreased vision. The exam showed Elschnig’s pearls, and the YAG opening was now smaller than the undilated pupil. The doctor performed a repeat YAG capsulotomy on the same eye. How should we code this? Will the procedure be reimbursed?Florida SubscriberAnswer: Because the second procedure happened outside the 90-day global period for the initial [...]
Question: I work in a physician’s office handling the collection of past due copays, deductibles, and coinsurance as well as the coding and claims. Can I send extremely delinquent accounts to the credit bureau or a collections agency even if the patient is paying a few dollars a month if the practice didn’t agree to a payment plan?Washington SubscriberAnswer: Yes, you can send information about delinquent accounts to collections agencies and/or credit bureaus – even if [...]
Use two new temp codes to represent the emerging laser corneal incision technology. If your ophthalmic surgeon is one of the trailblazers putting aside his trephine in favor of an advanced laser to perform corneal incisions and transplants, take heart. CPT® 2012 features two temporary codes that describe this emerging technology. CPT® Category III codes 0289T (Corneal incisions in the donor cornea created using a laser, in preparation for penetrating or lamellar keratoplasty [List separately [...]
ICD-10 Countdown: Get Ready or Get Fined — That’s the CMS Message (November 2011)
Explore 6 FAQs to ramp up your ICD-10 coding know-how.Denials aren’t the only thing you have to fear if your practice doesn’t implement ICD-10 by the Oct. 1, 2013 deadline. You could face fines, too, according to CMS. Based on comments from CMS representatives in recent CMS ICD-10 teleconferences, we’ve broken down six FAQs that promise to help you ramp up ICD-10 coding for your ophthalmology practice.Prepare for Medicare and Other PayersCMS has no intention [...]
Diagnosis Coding: 6 Tips Help Keep Your ICD-9 Coding on Track (November 2011)
Cheat sheets come with a warning label.To help ensure your coding complies with ICD-9 guidelines, there are several tactics you can use:1. Always read the notes in the ICD-9 manual that apply to the code you’re considering, says Denae M. Merrill, CPC, HCC coding specialist in Michigan. 2. Read the ICD-9 official guidelines that apply to your “specialty periodically as a refresher. If we only read them when the codes change once a year, it [...]
Visual Fields: 92081-92083 With Modifier 50? Not So Fast (November 2011)
Careful with those modifiers and dx codes, or you could be heading towards VF denials.Ophthalmologists usually spend a lot of time and effort helping patients who they suspect might have glaucoma. When a patient returns to your office for visual field examinations, can you code and bill the tests individually per eye? Can you bill for another visit to the office – including the actual test, verifying the results, and discussing them with the patient? How [...]
You Be the Coder: Cataract Removal With Pupil Stretching (November 2011)
Question: Our ophthalmologist wants me to submit a claim for 66982, along with stretching of pupil with iris hooks and staining of anterior capsule with vision blue dye. Are there separate codes for those services? Are they bundled?South Carolina SubscriberAnswer: You can’t claim them separately, but the use of iris hooks and blue dye in the anterior chamber will help back up your use of 66982 (Extracapsular cataract removal … complex …).Key: According to CPT®, “devices [...]
Reader Question: 92285 Requires ‘Track or Treat’ Evidence (November 2011)
Question: Our ophthalmologist performs external ocular photography for a Medicare patient with a malignancy on her left eyeball. Is this a covered service?New York SubscriberAnswer: Based on the patient’s diagnosis, Medicare should cover the external photography – if your ophthalmologist is taking the photos to “track or treat” the disease. Medicare will typically cover 92285 (External ocular photography with interpretation and report for documentation of medical progress) if the ophthalmologist is either:tracking the progression of the [...]
Reader Question: 92225-92226: Apply Initial EO Code to New Condition (November 2011)
Question: I’m confused about the extended ophthalmoscopy codes. Is 92225 for a new patient and 92226 for an established patient? Should I bill twice for both eyes?California Subscriber Answer: The extended ophthalmoscopy (EO) codes, 92225 (Ophthalmoscopy, extended, with retinal drawing [e.g., for retinal detachment, melanoma], with interpretation and report; initial) and 92226 (… subsequent), don’t correspond to new and established patients. CPT® does not intend for 92225 to be a one-time-only code, only to be used [...]
