You Be the Coder: Long-Standing Strabismus

Question: Another ophthalmologist referred a new patient with long-standing strabismus to us. How should I code this visit?

Colorado subscriber

Answer: The answer depends upon why the referring ophthalmologist sent the patient to your physician.

1) Was this a request for second opinion with recommendations for care?

2) Or was this referral due to a general ophthalmologist asking a second ophthalmologist who specializes in strabismus-related surgery to take over management of the patient's problem?

A consultation code (99241-99245) may be billed if the referral was for scenario #1 above. However, if scenario #2 is more accurate, then bill the office visit with code [...]

- Published on 2012-02-01