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Optometry Coding & Billing Alert

CPT® 2017:

Latest CPT Edition Updates Fluorescein Angiography Reporting

Changes could impact your reimbursement.

Although the calendar hasn’t yet turned to 2017, you should already be prepping for the New Year, because it could change the way you report fluorescein angiography. This change and others will be among the most impactful adjustments to CPT for optometry practices effective Jan. 1.

Caution:  These updates are based on the preliminary list of code adjustments, and changes may occur before the code set is final. Keep checking back in to Optometry Coding Alert for news about the final codes and details on proper use of your updated options.

Angiography Codes Now Bilateral

CPT 2017 will update two angiography codes to explain that the codes apply for both unilateral and bilateral procedures, as follows. The underlined text is the new verbiage:

This change could lead to a cut in reimbursement for optometrists, since you can currently append modifier 50 (Bilateral procedure) or modifiers LT (Left side) and RT (Right side) to 92235 and 92240 when billing bilaterally, allowing you to collect higher payments for bilateral services. Once the code changes go through as indicated above, it’s likely that you’ll only report one unit of 92235 or 92240 even if you perform the angiography service on both eyes.

Keep in mind: It is unclear whether CMS and other payers will adjust the RVUs for these codes due to the changes, but keep an eye on Optometry Coding Alert for more on these codes as payers release information about how to report them going forward.