Gonioscopy: 92020 Primer: Answer Bilateral, Dx Questions for Bulletproof Coding (January 2012)
3 answers to your frequently-asked gonioscopy questions.There may only be one gonioscopy code, but there are several ways you can sabotage your 92020 claim.When your optometrist performs a gonioscopy without general anesthesia, bilateral rules and reimbursable diagnoses can complicate your coding process. Tackle your coding dilemmas with these expert answers to your top gonioscopy questions.Question 1: Is 92020 Inherently Bilateral?Most insurance companies, including Medicare, consider 92020 (Gonioscopy [separate procedure]) a bilateral procedure code. This means [...]
Once ICD-10 is implemented in 2013, the diagnosis codes in the above story will be different. Check out this crosswalk for the correct borderline glaucoma diagnoses:Useful tool: Prepare for ICD-10 with SuperCoder’s ICD-10 Bridge, available exclusively on www.SuperCoder.com.
Medicare Errors: Providers Underbilled More Than $1 Billion to Medicare in 2010 (January 2012)
CERT results reveal $34.3 billion in improper Medicare payments – $1.1 billion of which was underpaid.If your practice’s collections rate was off by 10.5 percent, you’d be in big trouble, right? Well, that’s the 2010 Medicare Fee-for-Service improper payment rate, and your MAC may come looking for money you still owe to them.CMS’s new Comprehensive Error Rate Testing (CERT) results, which were released in November, show that practices actually made fewer errors in 2010 than in [...]
Documentation: Make Audit-Proof Record Corrections With These 5 Tips (January 2012)
Documentation clarifications can be a big help – if you use them wisely.With the plethora of government entities poring over more and more of your patient records, it may be time to use a valuable weapon: documentation corrections and additions. But overuse of late entries may do more harm than good.This is a topic of greater concern given the number of entities that are now looking at Medicare claims, warns consultant Judy Adams in Chapel Hill, [...]
Workers’ Compensation:5 Guidelines Ease the Pain of Billing Workers’ Compensation (January 2012)
If you don’t get pertinent information before seeing the patient, expect trouble when you start the billing process.If just thinking about processing a workers’ compensation claim gives you a headache, don’t worry – you aren’t alone. Remembering a few guidelines can help ease the pain.Problem: One of the major points of confusion is that, while workers’ compensation is authorized with federal guidance, it is a state-run program. That is, each state has its own rules, fee [...]
You Be the Expert: Exam Without Dilation (January 2012)
Question: Can we bill for a comprehensive eye exam with 92004/92014 if the optometrist did not dilate the patient and examine the eyes through dilated pupils?Massachusetts SubscriberAnswer: There are some instances when the optometrist may not think that dilation is needed for a thorough exam. A patient may have large pupils that the optometrist doesn’t need to dilate to get a good view. Or, the optometrist may think that a patient with certain conditions shouldn’t [...]
Reader Question: 92002 With V72.0 Is Fine With Most Carriers (January 2012)
Question: Our office has been coding exams (routine exams) as 92002 and V72.0 when we don’t see anything wrong. Would this raise any red flags?Texas SubscriberAnswer: No. You may use the general ophthalmological services code 92002 (Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient) with V72.0 (Special investigations and examinations; examination of eyes and vision). The V code indicates that the patient presented for a routine vision [...]
Reader Question: CMS Doesn’t Currently Require Billing Certification (January 2012)
Question: I attended a conference recently and a speaker said that CMS is or will be requiring that billers be certified. I hadn’t heard this information before. Is it correct?Nevada SubscriberAnswer: At this time, CMS has no certification requirements for either billers or coders.“CMS is not requiring any billing certification,” confirms Barbara J. Cobuzzi, MBA, CPC, CENTC, CPCH, CPCP, CPC-I, CHCC, president of CRN Healthcare Solutions, a consulting firm in Tinton Falls, N.J. “Only one [...]
CPT® 2012 Update: 92070 For Therapeutic Contacts? Not Anymore (December 2011)
New codes 92071 and 92072 carry the load for lens prescriptions for keratoconus and OSD.Although you can’t bill Medicare for regular refractive lenses, savvy optometrists know that you can expect reimbursement for contact lens prescriptions to treat keratoconus (ICD-9 codes 371.60-371.62) and ocular surface disorders (OSDs) like corneal abrasions and dry eye. However, what coders currently know is changing in 2012, with the deletion of one familiar CPT® code and the introduction of two new [...]
Part B Payment: Congress Votes to Boost Conversion Factor Through February 29. (December 2011)
At nearly the last minute, lawmakers ensure that you won’t lose 27 percent.Although the government appeared poised to take a big bite out of your next Part B payments, you have another two months before you need to worry about losing pay. That’s because the 27 percent Medicare pay cuts that practices have feared since last fall were once again kicked to the curb by Congress, resulting in a Medicare Physician Fee Schedule conversion factor [...]
