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Ophthalmology and Optometry Coding Alert

Correct Modifier Usage Key to Reimbursement For Retinal Detachment Repair With Epiretinal Membrane Stripping
Ophthalmologists often perform epiretinal membrane stripping at the same time as retinal d... Read more
Increase Payment for Removal Of Retained Cataract Remnants During Post-op Period
After removing remnants of a previous cataract surgery, some ophthalmologists dont bill fo... Read more
Modifiers Are Crucial to Coding For Trabeculectomy Done During Post-op of Trabeculoplasty
To ensure optimal reimbursement when a trabeculectomy is performed following a trabeculopl... Read more
Coding for Foreign Body Removal if There Is No Foreign Body
Frequently, ophthalmologists spend a lot of time searching a patients eye for foreign mate... Read more
Boost Reimbursement for 92083 For Arthritis, High-risk Medication and Lupus
Visual field testing can take up a lot of the ophthalmologists time, but they often have a... Read more
Reader Question:
92060 and Office Visit
Question: Can CPT code 92060 be billed to Medicare as a separate procedure when an offic... Read more
Reader Question:
Get Paid for Unbundled Codes
Question: We are still getting denials on gonioscopy (92020) when done the same day as an ... Read more
Reader Question:
No Payment for Trabeculoplasty at Same Time as Gonioplasty
Question: A patient has a trabeculoplasty (CPT 65855 ), and at the same time, the patient ... Read more
Reader Question:
Excision and Lid Repair
Question: We had a patient who presented with a basal cell carcinoma of the right-upper li... Read more
Get Medicare to Pay for Non-standard Glasses and Contacts After Cataract Surgery
Waivers are the key to getting paid when a patient chooses expensive frames and lenses (wh... Read more
Medicare Transmittal Clarifies Consultation
A new revision in the Medicare Carriers Manual (Transmittal 1644) means that ophthalmologi... Read more
Ophthalmologists Should Know About Two Codes for CPT 2000
Although CPT 2000 contains no new codes specifically related to ophthalmology, there are t... Read more
Reader Question:
Ganciclovir Implant
Question: What is the code for a ganciclovir implant? Anonymous IL Subscriber Answer: Ganc... Read more
Reader Question:
Closing Punctum Plug
Question: When billing for closure of punctum by plug, is it appropriate to bill for dilat... Read more
Reader Question:
Forced Ductions With No Anesthesia
Question: I was happy to see a response to my question regarding forced ductions (see July... Read more
Reader Question:
A-scan and B-scan Ultrasonography
Question: Weve had problems getting reimbursed for A-scan and B-scan ultrasonography (7651... Read more
Reader Question:
Coding Wound Repair After Trabeculectomy
Question: If an ophthalmologist needs to repair a wound following a trabeculectomy (66170)... Read more
Proving Medical Necessity for Cataract Surgery Crucial to Reimbursement
There was a time when an ophthalmology practice would get paid for cataract surgery, no qu... Read more
Improve Payment for Contact Lens Fitting for Disease
Theres a perfectly good code for contact lens fitting for diseaseits 92070 (fitting of c... Read more
Modifiers -25 and -57:
Get Paid for Minor Surgical Procedures and Office Visits
When a patient comes to an ophthalmologist with a complaint, and the physician can resolve... Read more
The Key to Reimbursement for Botox is Using Stock Wisely
Botulinum toxin (Botox) is very expensive ($370 for a 100-unit vial) and has a short shelf... Read more
Reader Question:
Supporting Medical Necessity
Question: What diagnosis codes support medical necessity for 67220? Anonymous IL Subscribe... Read more
Reader Question:
Billing for ASC
Question: Can an ASC charge be submitted for 15823?Bonnie GibbsMontgomery Eye CenterNaples... Read more
A-Scan/IOL Power Calculation:
Coding Made Simple for One of Medicares Most Confusing Policies
Many ophthalmologists have a hard time with claims for A-scans with intraocular lens (IOL)... Read more
Correctly Coding for the Complaint, Im Worried I Have a Cataract
Maybe the patients parents both have cataracts. Maybe a best friend just had cataract surg... Read more
Retina Specialists Beware:
Getting Reimbursed for 92225 Can Get Complicated
Extended ophthalmoscopy (92225, extended, with retinal drawing [e.g., for retinal detachme... Read more
How to Ethically Optimize Billing for the Tensilon Test
The Tensilon test (95857) is for myasthenia gravis, an abnormality of the nerve-muscle jun... Read more
Reader Question:
Coding for Plaquenil Toxicity Observation
"Question: What is the best way to code for Plaquenil toxicity observation: first, if the ... Read more
Reader Question:
Billing ofr Arcuate Keratotomy
Question: Is there a way to bill for AK when the patients astigmatism is not surgically in... Read more
Reader Question:
Correct Coding for Optic Nerve Evaluation
Question: In what instances can we use the new code 92135? EyeCare ProfessionalsReno, NV ... Read more
Modifiers are the Key to Getting Paid for Multiple Punctum Plugs
It is a uniquely ophthalmological situation: There are two eyes, and each eye has two duct... Read more
Optimal Billing for ED Patient With Eye Pain
Ophthalmologists are sometimes called to the hospital emergency department (ED) to see a p... Read more
Case Study:
Success with Medicare Appeals for Ptosis Repair and Blepharoplasty
We talk to many office managers and billers for ophthalmology practices who give up too so... Read more
Can You Bill for a Comprehensive Visit Along with Extended Ophthalmoscopy
Sometimes ophthalmologists will provide extended ophthalmoscopy (92225, initial drawing, 9... Read more
Optimal Billing When On Call for Other Providers
When one ophthalmologist is on call for another from a different group, what is the best w... Read more
Get Paid Retroactively Now That Medicare Unbundled Eye Codes
Last month, ophthalmologists got some good news from the associations that represent them ... Read more
Brief:
Revisions for E/M Documentation Guidelines: 20 Elements in Proposed Eye Exam
Ophthalmologists should be pleased by the recommended revisions of the Evaluation and Mana... Read more
Correct Billing for Second Glaucoma Surgeries in the Post-Op Period
Patients with serious glaucoma may need several operations. When these are done in the pos... Read more
Case Study:
Tips to Correctly Code an Emergency-Department Case
When an ophthalmologist is summoned to the emergency department (ED) of the local hospital... Read more
Avoid Causing Upset While Billing Medicare Patients for Refractions
When Medicare patients go to the ophthalmologist for a complete medical exam, they must be... Read more
Reader Question:
Forced Ductions
Question: What is the best CPT code to use for forced ductions? Lynn C. Day, Office Manage... Read more
Reader Question:
Repeat YAG Capsulotomy
Question: A YAG capsulotomy (66821) was done first in October of 1995. We didnt see the pa... Read more
Billing for Postoperative YAG Capsulotomy
When billing for a YAG capsulotomy (66821) during the postoperative period of cataract sur... Read more
Diagnosis Coding for Rule-Out Conditions:
Proceed with Caution
One of the hardest coding truths an ophthalmologist has to swallow is the one about rule-o... Read more
When You Can and When You Cant:
Writing Off Co-Payments, Deductibles, and More
Perhaps a Medicare patient has come in for an eye examination, including 92015 (determinat... Read more
Billing for Unrelated Problem Discovered by Other Physician During Postop Period
The following question comes from Ron D. Frame, OD, of Optometric Physicians of Parkersb... Read more
Optimal Coding for Exams Performed in Nursing Homes
I have free time on weekends and would like to do ophthalmological exams in some local nu... Read more
Reader Question:
Chalazion Removal
Question: We recently treated a patient for chalazion removal from the right and left eyel... Read more
Reader Question:
Billing for 66180 and 67255 at Same Time
Question: When a surgeon performs an aqueous shunt procedure (66180) along with a scleral ... Read more
Reader Question:
Strabismus Surgery
Question: We have a problem regarding the wording in the CPT book for primary strabismus c... Read more
Billing for Gonioscopy and External Photos in Same Session
Some Medicare carriers wont pay for both 92020 (gonioscopy) and 92285 (external ocular pho... Read more
Optimal Coding for Complications After In-office Surgery
Sometimes a relatively simple procedure evolves into totally unpredictable multiple visits... Read more
Getting Reimbursed for Blurry Vision Visits
So often patients call and request an appointment for blurry vision. When they get into th... Read more
Coding Within the Same Practice for Referrals to Sub-specialist
Scenario: A patient calls her ophthalmologist, who is part of a large group practice, to m... Read more
Determine Whats Included in Ophthalmological Services and Get Paid
Last years CPT revised the guidelines for intermediate ophthalmological services (92002,... Read more
Use -59 Modifier With Caution
Modifier -59 is to be used for a distinct procedural service. This is something that is di... Read more
Clarification:
E/M or Eye Exam Codes: Watch Your Local Carrier Bundles
Gonioscopy (92020), serial tonometry (92100), and sensorimotor examination (92060) were al... Read more
Reimbursement Tips for Extended Ophthalmoscopy
Extended ophthalmoscopy92225 for the first retinal drawing, and 92226 for subsequent drawi... Read more
Sometimes Even a Modifier Won't Help:
Keys to Coding Two Surgeons, Two Procedures, One Patient
When two ophthalmologists are performing surgery on the same patient at the same time, doi... Read more
Get Paid for a Multiple-Procedure Vitrectomy
Its not as easy to code multiple-procedure surgeries as it used to be. There are so many M... Read more
Improve Reimbursement for Consults and Special Services on the Same Date
When you are asked to examine a patient on a consultation basis, and you need to perform a... Read more
Reader Question:
Giant Papillary Conjunctivitis Code?
Question: What is the correct ICD-9 code for giant papillary conjunctivitis?Brian D. Salme... Read more
Reader Question:
How Far Back Can You Bill to Recover Lost Revenue?
Question: When I took over as bookkeeper, I found that all fluorescein angiography [FA, 92... Read more
Reader Question:
Coding Retinopathy of Prematurity
Question: I am often asked to evaluate patients to rule out retinopathy of prematurity (R... Read more
Get Compensated for Consultations:
Document and Code Appropriately
The office and other outpatient consultation codes (99241-99245) are to be used when a phy... Read more
Get Your Ophthalmologists Involved in Coding
Ophthalmologists keep up to date with the latest research. They are akin to physicists whe... Read more
Documenting a Fourth-Level Visit for a Cataract Evaluation
What do I need to bill a fourth-level visit? is a question many ophthalmologists askusuall... Read more
Improving Payment for Punctal Plugs
Placing punctal plugs (implants which help to keep the cornea moist by blocking the punctu... Read more
Avoid Lost Revenue, Stay On Top of External Billers
When someone outside of your office does your billing, it is to your practices benefit to ... Read more
Reimbursement Tactics for Refractions
Medicare doesnt pay for refractions; some private policies do, but most dont. How can opht... Read more
Bilateral Billing for Angiograms and Fundus Photography
When charging for fluorescein angiography (92235) and for fundus photography (92250), ho... Read more
Modifiers -24 and -25:
For Eye Codes as well as E/M Services Codes
Ophthalmology coders may have noticed that the very useful modifier -25 (for a separate se... Read more
Maximizing Reimbursement for Discussing Surgery Options
A common question in ophthalmology is: How do you receive additional reimbursement for the... Read more
Billing for Ophthalmologists and Optometrists in Same Practice
Many practices have ophthalmologists and optometrists on staff, and sometimes there is con... Read more
Reader Question:
Complicated Implants
Question: A patient has deposits of pigment on the anterior lens surface -- an implant -- ... Read more
Reader Question:
Office Visit With 92100
Question: Can you file an office visit with 92100 (serial tonometry)? Question submitted a... Read more
Reader Question:
Periocular Injections
Question: What code is used for a periocular injection? Brenda Purvis, Valley Eye CenterVa... Read more
Reader Question:
Complications of Surgery
Question: Postoperatively to a vitrectomy, the patient was returned to the operating room ... Read more
Reader Question:
Lacrimal Microtube Supply Billing
Question: If a lacrimal microtube is placed in the office, how should we bill for the tube... Read more
E/M Documentation Guidelines:
Eye Experts Say Use 1997, Not 1995 Version
The Health Care Financing Administration (HCFA) says you can use either the 1995 or the 19... Read more
Accurate Diagnosis Codes and Modifiers Crucial for Post-Exam Payup After 66821
When YAG laser surgery (66821) is performed on a patient, and you see that patient within ... Read more
Proven Corneal Topography Reimbursement Tactics
Corneal topography has no procedure code, and most practices we spoke to dont even bother ... Read more
Three Tips for Getting Paid for Fundus Photos and Eye Exams
Getting paid for doing fundus photography and an examination on the same date can be dif... Read more
Reimbursement Tips for Time Spent Training Residents
An ophthalmologist (who would like to remain anonymous) is on staff at a hospital with a r... Read more
Maximizing Reimbursement for Post-Op Period of Cataract Surgery
Coding for the 90 days following cataract surgery can be tricky. Thats because there are f... Read more
Optimize Billing Efficiency with Technician-Coder Team
If you are worried about claim denials, up to your ears in last-minute precertification re... Read more
Reimbursement for the Use of One Vial of Botulinum Toxin for More than One Patient
Botulinum toxin is a very fragile pharmaceutical. Once the vial is opened, it must be used... Read more
Available Years:  1999  1998