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Ophthalmology & Optometry Coding Alert

2019 Coding:
3 Tips Aid You in Reporting the 2019 CPT®, Diagnosis Codes
Hint: Evaluate laterality carefully when picking a diagnosis. Eye care practices have bee... Read more
Concurrent Care:
Account Carefully When Reporting Concurrent Care
Hint: Differentiate this service from duplicative care. Concurrent care scenarios are amo... Read more
CCI Edits:
CMS Clarifies Modifier 59 Usage Rules
Keep these tips in mind when deciding whether to separate edits. Some coders are so accus... Read more
Modifier 59 Isn’t Automatically the Best Choice
Although CMS has clarified its regulations for when you can report modifier 59 (... Read more
Compliance:
Perform Self-Audits Efficiently With These 3 Tips
Dig into your records and get the pulse of your practice's health As Medicare auditors st... Read more
You Be the Coder:
Bilateral Modifier Rules Can Get Confusing
Question:  Thank you for your article last month about bilateral coding. I have a fol... Read more
Reader Question:
Chief Complaint Must Venture Beyond Follow-up
Question: Our ophthalmologist lists the chief complaint for all follow-up visits using jus... Read more
CMS Pay:
Optometrists Logged Nation’s Highest DME Improper Payment Rate
Plus: Ophthalmologists suffered from upcoding errors. No one has ever said that coding fo... Read more
Get to Know CMS’ Evaluation Criteria
CMS identified a total of $31.6 billion in total improper payments among providers during ... Read more
Unilateral/Bilateral Coding:
Do You Know Which Diagnostic Tests Are Inherently Bilateral?
The difference could change how you code your claims. Eye care coding often hinges on whe... Read more
Check These Examples of Unilateral, Bilateral Eye Services
Before you report the bilateral modifiers on your claim, make sure you know whether your e... Read more
ICD-10 Coding:
Do You Have Signs and Symptoms Questions? We’ve Got Answers
Find out what to code – and what to leave off your claims. Reporting ICD-10 codes isn't... Read more
You Be the Coder:
Are You Prepared to Bill Incident to?
Question: We recently hired a nurse practitioner at our ophthalmology office and have... Read more
Reader Question:
Vet Your Employees – Avoid This Ophthalmologist’s Fate
Question: We are creating a new compliance policy, in which we'd like to include backgroun... Read more
Reader Question:
Get A Handle on New Vs. Established Patients
Question: We were recently audited and an established patient visit was marked as incorrec... Read more
Vision Care Coding:
MAC Rep: You Can Decide Whether to Report Refraction to Medicare
These and other questions were answered recently by one payer. Coding for eye care specia... Read more
2019 Payment:
Look Ahead to 2021 for Info on E/M Changes
Keep an eye on what may be coming up the pike. If your eye care staff members have been o... Read more
Looking Ahead:
Here's What to Expect in 2021
Although CMS won't be instituting big changes to E/M coding and documentation when the cal... Read more
Dry Eye Coding:
3 FAQs About Collecting for Schirmer's Testing
Hint: You won't find a code for the service in your manual. If you see patients with dry ... Read more
Reader Question:
Update Patient Records As New Cards Arrive
Question: We recently received a remittance advice and the number on it didn't match the n... Read more
Reader Question:
Go Beyond Diagnoses for YAG Laser Denial
Question: Our ophthalmologist used a YAG laser (66821) for a diagnosis of “vitreous stra... Read more
Reader Question:
Pinpoint SLT, ALT Codes
Question: If the physician performs SLT for glaucoma, which code should we report? What ab... Read more
You Be the Coder:
Watch Terminology With Consults
Question: Thank you for your article last month about consult coding. One of our main paye... Read more