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Optometry Coding & Billing Alert

8 Things Your Optometry Practice Must Know About MACRA & MIPS in 2017
Good news: 2017 is a ‘Get Out of Jail Free’ card. Confused about what the ... Read more
Revenue Boost:
Is Your Practice's Optical Shop As Profitable As It Can Be?
This 6-question test says for sure. If you’re like most optometry practices, you... Read more
Revenue Boost:
Are Remakes Eating Away at Your Optical's Profits?
You don’t shell out for the cost of remakes immediately, but if you have a high re... Read more
Revenue Boost:
Fortify Optical Profits with Multiple Pair Sales, Upgrades
If your capture rate is good, congratulations! Now it’s time for your optical to m... Read more
Practice Management:
Schedule Your Way to Optimal Practice Profitability in 2017
6 ways to improve patient flow in your optometry practice. How can your practice stay ... Read more
Is Open Access Scheduling Right for Your Optometry Practice?
Make no mistake — your scheduling strategies can make or break your bottom line. (... Read more
Revenue Boost:
Dry Eye: Make the Most of Out-of-Pocket Revenue Opportunities
Diagnositic tests may not boost revenue, but they have other benefits. Insurance reimb... Read more
Does Your Back Office Have an A/R Problem? Here's How To Tell
Focus on these 2 benchmarks. Wondering how your optometry practice is doing when it co... Read more
CPT® 2017:
Latest CPT Edition Updates Fluorescein Angiography Reporting
Changes could impact your reimbursement. Although the calendar hasn’t yet turned... Read more
CMS: Blepharoplasty Claims the Cause of Numerous Errors
No visual field testing? No Medicare payment, latest compliance newsletter says. You m... Read more
Take This Advice And You'll Never Chase Down A Copay Again
Obtain signed financial responsibility form as insurance against nonpayment. Most medi... Read more
Avoid Confrontation at All Costs When Collecting Copays
Experts: Give patients a few chances to pay, then call collections. A patient flat-out... Read more
Patient Privacy:
10 Tips Help You Avoid 'Insider Threats'
Hint: Establish a baseline to spot suspicious employee behavior. Although the thought ... Read more
You Be the Expert:
Know Your Bilateral Rules
Question: Our patient was working on a building demolition and ended up with small ... Read more
Reader Question:
Avoid Modifier 50 for 92010
Question: Is 92020 (Gonioscopy [separate procedure]) inherently bilateral? Superc... Read more
Reader Question:
Know Contact Lens Rules With Keratoconus
Question: We know we can’t bill Medicare for regular refractive contact lense... Read more
Optometry Mythbuster:
Don't Perform Surgeries? Global Periods Still Apply to You
Even minor procedures have global periods associated with them. Myth: Because opt... Read more
This Optometrist Had to Return $150K to Medicare
Ensure that you don’t face the same fate with these FAQs. An optometrist in Okla... Read more
E/M Coding:
Are You Making This $31 Mistake?
  Determine whether you can accurately code this eye care chart.  Would th... Read more
Look to 6th Digit for Most Hypotony Diagnoses
Cause of condition may ease your code selection woes. When your optometrist sees a pat... Read more
You Be the Expert:
Stamped Signatures Typically Taboo
Question: What are the specifics regarding provider signatures on claims? Is it eve... Read more
Reader Question:
Handle Potential HIPAA Breaches With Care
Question: Our receptionist was asked to fax a patient’s eye exam results to h... Read more
Preventive Services Mythbuster:
Bust These Glaucoma Screening Myths to Secure Medicare Pay
Hint: Medicare may not view a year the same way your calendar does. Your optometry pra... Read more
Master Co-Management to Ensure the Happiness of Patients, Doctors -- and Auditors
Never imply that co-management is an agreement to refer, experts advise. For eye care ... Read more
Code to the Sixth Digit for Your Astigmatism Patients
Documentation of ‘regular’ vs. ‘irregular’ will help ease your c... Read more
You Be the Expert:
Keep Close Eye on Frequency Guidelines for 92065
Question: Our optometrist performed orthoptic training every two weeks for eight mo... Read more
Reader Question:
Don't Let Time Crunch Cost You Money
Question: I read your article last month where you advised asking patients for thei... Read more
Reader Question:
Who Qualifies As a Business Associate?
Question: I have read about business associate agreements (BAAs) in past issues of ... Read more
Vision Benefits:
Optometrist Is in Driver's Seat When Managing Annual Vision Benefit
Ensure that the OD is aware of the patient’s benefit before recommending contacts ... Read more
Consider These 3 Key Takeaways Before You Hire A Billing Company
Hint: Compliance is as important as billing and coding when reviewing potential outsourc... Read more
Help Make Sense of Your Eye Care Claims With 'Z' Codes
These diagnoses can support screenings and much more. Remember the ‘V’ cod... Read more
These Z Codes Can Make Your Claims Shine
Eye care practices that are unfamiliar with additional Z codes beyond the ones mentioned... Read more
Practice Management:
Consider These Tips When Discharging A Patient From Your Practice
Remember to use certified mail whenever possible. Your patients are your bread and but... Read more
You Be the Expert:
Don't Look to 90863 for Med Management
Question: Which code(s) should we report to describe our services providing medicat... Read more
Reader Question:
Replace Modifier 50 With Modifier 26 in This Scenario
Question: Our optometrist calculated IOL power in both eyes, and we reported 76519-... Read more
Reader Question:
Check CCI Before You Bill
Question: We are having trouble collecting for both 92250 and 92133 when the optome... Read more
Correct Coding Initiative:
Don't Get Burned by These New CCI Edits
Experts advise on the best way to collect when CCI comes calling. Sometimes it seems l... Read more
Let Your No-Show Policy Speak for You When Patients Skip Appointment
A robust policy will prevent write-offs for your optometry practice. When patients don... Read more
Practice Management:
At First Sight: Your Reception Area Sets the Tone for Your Office
Don’t make a bad impression when patients walk through your front door. When a p... Read more
Patient Population Should Drive Reception Decor
Pediatric optometrists will have different waiting rooms than those seeing cataract pati... Read more
You Be the Expert:
Contract Verifications Don't Automatically Lead to Audits
Question: Our medical office recently received a contact verification email from OC... Read more
Reader Question:
Look to Documentation for E/M Clues
Question: Our optometrist removed a foreign body from a patient’s eye. Can we... Read more
Reader Question:
P&L Statements Could Offer Treasure Trove of Information
Question: I read your article on benchmarking last month with great interest (Vol. ... Read more
Reader Question:
Check Reason for Visit When Looking at 99050
Question: Can we report 99050 for a walk-in patient who came to our clinic after we... Read more
Ocular Surface Disease:
3 Tips Help You Collect When Treating Dry Eyes in Content Lens Patients
Hint: Treating OSD is completely separate from training patients on lens care. Most co... Read more
Majority of Optometrists' Ophthalmic Codes Nationwide Are Level 4
Use this carrier’s data to compare your billings to other optometrists across the ... Read more
Palmetto Weighs in:
E/M Codes Vs. Eye Codes
Many optometry practices struggle with the question of to use standard E/M codes for the... Read more
Diagnosis Dilemma
The Palmetto auditors looked at whether diagnosis codes were submitted to the highest le... Read more
3 Tips Help Your Optometry Claims Sail Through After ICD-10 Grace Period Ends
You’ve got three months left to simply code in the right ‘family.’ I... Read more
Here's How to Track Your ICD-10 Progress, CMS-Style
Not sure where you stand in terms of your ICD-10 progress at this point? CMS offers deta... Read more
You Be the Expert:
Does A Letter Count as A 'Medical Record?'
Question: Our optometrist circled 99213 on his chart, but the only note in the reco... Read more
Reader Question:
Request Written Medical Policy
Question: I contacted my insurer and asked how they prefer me to submit codes for a... Read more
Reader Question:
Some Health Apps Must Be HIPAA Compliant
Question: Our optometrists are using more and more apps for a variety of reasons, i... Read more
Expanded Dx Codes May Be Coming for Diabetes With Ophthalmic Complications
Also, look for new retinal vein occlusion, AMD, glaucoma, and amblyopia options. ... Read more
Master These Eye Modifiers and Keep Your Claims Crystal-Clear
Do you know which modifiers may affect your payments? Even if you’re brand-new t... Read more
Sneak Peek: Here's What to Expect in Your Next HIPAA Audit
Ensure that your program discusses how to cover these details to prep for an audit. Do... Read more
You Be the Expert:
Refraction Without Prescription
Question: Is it appropriate to bill a patient for 92015 even if we don’t give... Read more
Reader Question:
Put Locum Tenens Rules to Work for You Using These Tips
Question: Our practice recently hired a locum tenens (LT) physician to fill in for ... Read more
Reader Question:
Base Coding on HEM, Not Visit Type
Question: I have a provider that saw a patient on Monday and coded a 99214. He then... Read more
Could One of These Myths Be Sinking Your EO Claims?
Extended ophthalmology coding has a few sticking points – read on to smooth your w... Read more
Glaucoma Coding:
Part II: Zoom In on Glaucoma Screening, Testing Rules
Do you know which codes should only be used with Medicare patients? Last issue, we bro... Read more
Practice Management:
Monitor Claims to Max Out Your Optometrists' Pay
Keep your AR up-to-date. You’re up-to-date on coding changes, you’ve educa... Read more
Report: Many Practices Are Unprepared for Coming HIPAA Audits
No privacy officer? Then you aren’t HIPAA compliant. As Part B practices nationw... Read more
You Be the Expert:
Foreign Body Sensation With No Foreign Body?
Question: What is proper diagnosis coding if a patient comes in with a foreign-body... Read more
Reader Question:
Ensure Valid Provider Signatures
Question: I’m having trouble getting my optometrists to sign their claim form... Read more
Reader Question:
Make Sure Patients Understand EOB's Purpose
Question: We often get patients who call the practice with questions about their ex... Read more
Dry Eye:
Plenty of Dry Eyes in the House - Here's How to Safeguard Your Reimbursement
Nearly $150 is at stake each time. With nearly 78.5 million Americans suffering from d... Read more
Glaucoma Coding:
Part I: Watch Risk Factors, Screening Rules to Navigate Glaucoma Coding Angles
Tip: Specify which eye is affected to nail the proper ICD-10 code. According to the Gl... Read more
Get Better Information from Patients to Thwart Billing Mistakes
Tip: Don’t just ask, “Has your insurance information changed?” We&rs... Read more
You Be the Expert:
Epilation of Lashes by Forceps
Question: The optometrist used forceps to remove an ingrown eyelash. What CPT® ... Read more
Reader Question:
Just One Dx Code for Diabetic Retinopathy
Question: For a diagnosis of diabetic retinopathy with ICD-10 codes, do we still ha... Read more
Reader Question:
Charge Patient Difference for Deluxe Frames
Question: What are the criteria to bill for deluxe frames with V2025 for a post-cat... Read more
Reader Question:
Use Split Visit Rules to Duck 15 Percent Pay Cut
Question: I’ve heard nurse practitioners (NPs) and other providers talk about... Read more
Reader Question:
Get Consent Before Disclosing Test Results
Question: When an employer pays our office to perform vision tests, can we disclose... Read more
Diagnostic Tests:
Part III: SCODI, FA, Fundus Photography, and Gonioscopy Round Out Your Diagnostic Coding Arsenal
Warning: Don’t get tripped up by tricky bilateral rules. In the last issue of Op... Read more
Target Your EHRs for Scrutiny
Watch incentive payments, too. HIPAA enforcement just keeps getting tougher — th... Read more
Keep PC/TC Rules in Mind for Tech's Work in Ophthalmic Test Claims
Hint: Look for the modifier indicator in the Medicare fee schedule for guidance. Many ... Read more
You Be the Expert:
Low Vision Aids
Question: Our practice is considering dispensing low-vision aids. How should we cod... Read more
Reader Question:
Also Report Endophthalmitis Cause
Question: The ICD-10 description for endophthalmitis now says to “use additio... Read more
Reader Question:
Include Single Tonometry in General Ophthalmological Services
Question: Our ophthalmologist renders single-episode tonometry services on her pati... Read more
Reader Question:
Medicare Won't Pay? Get ABN Anyway
Question: Are patients undergoing keratoconus workup or contact lens fitting still ... Read more
Diagnostic Tests:
Part II: Refraction, Topography, Visual Fields -- Keep Your Diagnostic Test Coding On Point
Follow these expert tips for CPT® 92015, 92025, and 92081-92083. In the last issue... Read more
H47 Family Holds the ICD-10 Answers for Optic Chiasm, Visual Cortex Disorders
Check detailed codes for side specificity. If you’re in a neuro-ophthalmology pr... Read more
Know Your Vulnerabilities Before Auditors Come Knocking
Focus on these hotspots to reduce audit risk. Even if your practice puts the stronges... Read more
Electronic Health Records:
Know How You Can Stay Abreast of Your EHR System Using These 3 Tips
Surprisingly, EHRs adding to difficulties instead of reducing workload, says study. If... Read more
You Be the Expert:
Low-Risk Glaucoma Screenings
Question: Our office sometimes performs glaucoma screenings for patients who don&rs... Read more
Reader Question:
Determine PFSH for E/M Choice
Question: I have a note for an office visit that clearly indicates a comprehensive ... Read more