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Ophthalmology & Optometry Coding Alert

Diagnostic Tests :
Part I: Are You Coding Diagnostic Tests Correctly?
From refractions to EO, read on for a refresher of the general rules and guidelines for ... Read more
ICD-10 :
Watch H54 Family for Streamlined Visual Impairment Coding
Choose from 17 codes for blindness, low vision conditions in either eye. While the eno... Read more
Medicare Physician Fee Schedule :
Get These Updates to Global Surgical Package and Incident- To Billing
Fees and compliance issues lead providers’ concerns. First, the good news &mdash... Read more
Reader Question :
Avoid ICD-9 and ICD-10 on 1 CMS-1500 Form
Question: Our physician admitted a patient in September and didn’t discharge ... Read more
Reader Question :
Look to Z98.4 for Cataract History
Question: When coding for cataract surgery, is it required or optional to code Z98.... Read more
Reader Question :
Pinpoint POS Codes with This Quick Guide
Question: I have heard that MACs are paying close attention to our place of service (POS... Read more
You Be the Coder :
Epilation and E/M During YAG Global
Question: One of our patients is still in the global period for a YAG laser procedu... Read more
Extended Ophthalmoscopy:
Know the EO Rules to Safeguard Deserved Payment
Don’t let coding errors rob your practice of $28 each time. With approximately $... Read more
Coding Quiz:
Are You Up on CPT® 2016?
Codes for corneal ring segments, among others, are coming – test your knowledge no... Read more
ICD-10:
Get to Know Your 30 New Options for Vitreous Disorders
The diagnosis code set expands nearly fourfold with H43 series. As coders nationwide h... Read more
ICD-10:
Practices Report Mostly Smooth Sailing Through ICD-10 Transition
Some potential issues, however, may remain to be seen. If you asked medical practices ... Read more
ICD-10:
Understand Grace Period
Check out these resources, too. You’re using ICD-10, and you’re not too su... Read more
Reader Question:
Append Modifier 25 for E/M With Plug Insertion
Question: When my optometrist does a comprehensive exam (92004) and decides to inse... Read more
Reader Question:
"No Charge" Visits Still Count Toward Established Patient Status
Question: Our ophthalmologist saw a patient during a quick assessment last year at ... Read more
Reader Question:
Use "Other" ICD-10 Codes With Caution
Question: If I find that a common ICD-9 code that I use doesn’t have a dir... Read more
You Be the Coder:
Complex Cataracts With Iris Hooks,Staining
Question: Our ophthalmologist wants me to submit a claim for 66982, along with stre... Read more
CPT® 2016:
Get Ready for Corneal Ring Segment, Collagen Cross-Linking Codes
New and revised procedure codes reflect improving technology. Along with the changing ... Read more
ICD-10:
Seek Out H47 Series for Optic Disc Disorders
With the new diagnosis codes officially in play, say goodbye to the 377.xx ICD-9 codes. ... Read more
ICD-10:
Follow These Essential Tips to Embrace ICD-10 Implementation This Month
What is new ahead? See more combination codes and seventh digits; You needn’t fear... Read more
Compliance:
Ophthalmology Providers in WV, NJ Logged High Error Rates
Ophthalmology Providers in WV, NJ Logged High Error Rates OIG report shines spotlight ... Read more
Reader Question:
Obey the 60-day Max for Locum Tenens
Question: We will employ a substitute physician to fill in for one of our ophthalmo... Read more
Reader Question:
Avoid EO Denials With Proper 92225-92226 Use
Question: I just got a denial on 92226. I think I might be using this code incorrec... Read more
You Be the Coder:
Levator Resection With Blepharoplasty
Question: Our oculoplastic surgeon performed levator resection and blepharoplasty o... Read more
Retinal Procedures:
Initial, Subsequent, Bilateral, Unilateral: Here's How to Clear Up Your Retina Coding Myths
Tip: CPT® code 67112 isn’t always for subsequent repairs. With thousands of ... Read more
ICD-10:
More Changes Coming for Visual Disturbances Dx
H53 family also covers visual field defects, color vision deficiency, and night blindness.... Read more
ICD-10:
5 FAQs Quell Confusion on CMS's Latest ICD-10 Announcement
The one- year grace period for ICD-10 claims applies to Medicare only. If CMS’s ... Read more
Reader Questions:
Don't Report ICG Dye Separately for 92240
Question: One of our physicians wants to know if we can bill for indocyanine-green ... Read more
Reader Questions:
Distinguish Facility vs. Non-Facility Fees
Question: Can you please explain whether we should use the facility global fee or t... Read more
Reader Questions:
Know Documentation Requirements for Provocative Glaucoma Tests
Question: What testing and documentation do I need to bill for 92140 (Provocative t... Read more
You Be the Coder:
Glaucoma Screenings
Question: A Medicare patient presented for a glaucoma screening. He had no personal hist... Read more
Office Visits:
Here's How to Make the E/M vs. Eye Codes Choice Simple
You’ve got two options for coding office visits – here’s how to decide... Read more
Eye Code or E/M Code?
Consult this guide before picking a code for your next office visit.  E/M Codes: ... Read more
ICD-10:
Check These Visual Disturbances Dx Changes
Tip: Some codes ranges have been expanded to show laterality. Like many of the current... Read more
CCI Update:
CCI 21.2 Changes Your Ectropion, Entropion Repair Coding
Modifier indicator may let you override bundling. The latest set of Correct Coding Ini... Read more
Reimbursement:
January Could Bring Changes for Incident to Services
New Medicare Physician Fee Schedule proposal brings pay raise next year. For the first... Read more
Reader Question:
Choosing New vs. Established Patient Codes
Question: What is the difference between a new and established patient, for office ... Read more
You Be the Coder:
Second Cataract Removal Within Global
Question: On June 1, our ophthalmic surgeon performed an extracapsular cataract rem... Read more
Contact Lenses:
Contact Coding Story Doesn't Stop at 92310
Get your deserved reimbursement for medically necessary lenses. Seasoned ophthalmology... Read more
ICD-10:
New Dx Codes Add Laterality for Most "Other Specified" Glaucoma
H40.89 will cover many “other” conditions. Starting Oct. 1, 2015, ophthalm... Read more
Gonioscopy:
Are These Myths Holding Back Your 92020 Claims?
Get to know the post-op, bilateral billing rules for gonioscopy. Gonioscopy may not be... Read more
Reader Questions:
Billing EO Separately? Read This First
Question: A patient reports flashes and floaters but the ophthalmologist does not find e... Read more
Reader Questions:
Modifiers Key to Successful E/M, VF, Temp Plug Claim
Question: A patient came in for visual field (VF) tests. During the same visit, the... Read more
Reader Questions:
Don't Charge 92250 Without Diagnostic Basis
Question: If you perform 92250 (Fundus photography) on a patient with diabetes and ... Read more
You Be the Coder:
Testing for Plaquenil Effects
Question: When the ophthalmologist performs OCT on a patient using Plaquenil for rh... Read more
AMD:
Coding Age-Related Macular Degeneration Tests Separately? Read This First
Know which type of AMD the patient has for complete coding success. Age-related macula... Read more
Coding Quiz:
Test Your Intraocular Lens Coding Prowess
What would you do in these scenarios? Each year, surgeons implant more than 6 million ... Read more
ICD-10:
H40.6 Family Holds Key to Corticosteroid-Induced Glaucoma
Tip: Each character in the ICD-10 code tells you something specific about the condition.... Read more
Coding Quiz Answers:
Read Our Expert Solutions to the IOL Coding Scenarios
Every cataract procedure includes an IOL – but there are situations where separate... Read more
Reader Questions:
65205, 65222 Get It Done for Conjunctival, Corneal FBRs
Question: A patient reported with a foreign-body sensation after mowing the lawn an... Read more
Reader Questions:
Don't Get Zapped by ERG Bilateral Rules
Question: Can I code an electroretinogram bilaterally? Colorado Subscriber Answ... Read more
Reader Questions:
Focus on Payer Rules Governing 51 Use
Question: I have heard our coders saying that they don’t need to attach modif... Read more
You Be the Coder:
Tracking Glaucoma and DR Progress
Question: The ophthalmologist is monitoring a patient who has glaucoma and diabetic reti... Read more
Retinal Detachments:
67101-67113 Primer: Know What's Involved in Procedures to Correctly Code Claims
Tip: 67101 and 67105 include one or more repair sessions. Retinal detachments are almo... Read more
ICD-10:
Close In on New Dx Codes for Primary Angle-Closure Glaucoma
Hint: Know the significance of each character to identify most accurate code. In ICD-1... Read more
Reader Questions:
Look for Clinical Circumstances to Code Bleph and Ptosis Repair
Question: Can CPT® codes 15823 and 67904 be billed together? Would I need a mod... Read more
Reader Questions:
Use 371.43 for Calcific Band Keratopathy
Question: I have a patient with extreme calcific band keratopathy. Is there a more ... Read more
Reader Question:
Report 92100 Only Once for Multiple IOP Tests
Question: How would I code for four appointments for a single patient to map intrao... Read more
Reader Question:
Don't Fear ICD-10 Transition
Question: I’ve been told that ICD-10 will be nearly impossible to use because... Read more
You Be the Coder:
Corneal Filaments
Question: Is removal of corneal filaments billable? And if so, what code would you ... Read more
CCI Update:
CCI 21.1 Debuts Bundles for Anterior, Intravitreal, Subconjunctival Injections
Thinking of reporting an injection separately from a cataract removal?  Think again... Read more
ICD-10:
Explore H44 for More Disorders of the Globe Dx
Degenerative myopia, siderosis diagnoses will specify affected eye. In our last issue,... Read more
E/M Coding:
3 Ways Comparative Billing Reports Can Rescue Your Coding
Use the CBRs as springboards to gauge your accuracy. Your MACs are reviewing the most ... Read more
Part B Payment:
Congress Votes to Overhaul Part B Payments
You’ll no longer face potential payment drops at the beginning of each New Year. ... Read more
Billing:
These 6 Tips Will Transform Your Accounts Receivables
Coordinate back office and front desk staff to keep cash flow positive. You know you&rsqu... Read more
Reader Questions:
No Unusual Documentation Needed for Large Bifocal Segs
Question:  I’m really confused about codes V2219 and V2319 for Medicare patient... Read more
You Be the Coder:
Repeat Focal Laser
Question:  IA patient returns during the 90-day postoperative period of a focal l... Read more
Ophthalmic Trauma Care:
Focus on 65205-65222 and 65270-65286 for Eye Injury Claims
Tip: Foreign body removal can be included in the corneal repair. Although it’... Read more
ICD-10:
Zoom In on H44 Codes for Endophthalmitis, Other Disorders of Globe
New diagnosis codes break condition down by left, right, both or unspecified eyes. Whe... Read more
Reimbursement:
Medicare Physician Fee Schedule: Watch for Possible April Pay Cut
But an act of Congress can save the day. So far this year, you should be experiencing ... Read more
Compliance:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20... Read more
Reader Questions:
Clear Up Patient Medicare Confusion
Question: We have a patient asking why she has to pay anything when we accept assignment... Read more
Reader Question:
E/M, Eye Codes Don't Include Refraction Services
Question: For refraction, should I report a 992xx or 92xxx exam code? Maine Subscrib... Read more
You Be the Coder:
Trabeculectomy Suture Removal
Question: I am trying to bill for the removal of sutures the ophthalmologist placed duri... Read more
Strabismus:
Is One of These Strabismus Myths Making Your Coding Askew?
Keep on top of bilateral rules, diagnoses, and separate procedures to keep your claims s... Read more
ICD-10:
Q10.- Has Your Congenital Eyelid Malformations Dx Answers
Get ready: Implementation date is still set for this October. Unlike many of the ICD-1... Read more
Testing:
Don't Let Unanswered IOL Power Calculation Questions Cloud Your Reimbursement
Read on for our expert answers to these 76519 and 92136 head-scratchers. Calculating i... Read more
Medicare Errors:
Let CERT Findings Focus E/M Claims
Avoid key documentation mistakes that cost you pay. Imagine if you lost 10 percent of ... Read more
Reader Question:
Add to Your ICD-10 Know-How
Question: I’ve heard that ICD-10 doesn’t have an equivalent to V codes ... Read more
Reader Question:
Don't Bill Patient for Records Transfer
Question: Our practice discharged a patient due to non-payment, and one week later a ... Read more
You Be the Coder:
Abandoned Photocoagulation
Question: After discussing the risks and benefits of both cryotherapy and photocoag... Read more
Blepharoplasty:
Think 15820-15823 and 67901-67908 Are Interchangeable? Think Again
Read these frequently asked questions before coding your next eyelid procedure claim. ... Read more
Reimbursement:
Final Fee Schedule Confirms Phasing Out of Global Periods
Ophthalmology practices, prepare for a 2 percent cut to Medicare payments. When CMS annou... Read more
ICD-10:
Keep Your Eye on Revised Retinal Detachment Diagnosis Codes
Substitute these H33.--- codes for the 361.xx ICD-9 codes. As with many of the diagnos... Read more
Billing:
Get Comfortable with Unruly Consolidated Billing Rules
Uncover who, what, and when to bill so you get your money. Knowing whether your skille... Read more
Reader question:
Know This 375.15 & 370.21 Distinction
Question: Can 375.15 and 370.21 be used interchangeably? When would one be the pref... Read more
Correction
The answer to the “You Be the Coder” question in Opthalmology Coding Alert V... Read more
Reader Question:
Appeal Is an Option When Patient Prevents Timely Filing
Question: We have a timely filing concern. Our physician saw a patient who didn&rsq... Read more
You Be the Coder:
Unilateral OCT
Question: We performed an OCT on a patient’s left eye, and filed the claim wi... Read more