Ophthalmology and Optometry Coding Alert

Plus, you may finally get paid for ocular photoscreening January is the time to implement new and revised CPT codes, and ophthalmology practices will have a lot to digest this year, including a new retinal detachment code and several new Category III codes for services such as intraocular pressure monitoring during vitrectomies. Don't delay: These new codes take effect on Jan. 1, and CPT expects coders to start using them right away. Remember that there is no longer a grace period for you to get used to the new codes. Good news: The 2008 changes should be beneficial for your practice. "I think most of these codes give a more specific definition, and it appears that there is room for a higher reimbursement when a more complex procedure is performed by the physician," says Katie Stillman, coding specialist for EYE Q Vision in Fresno, Calif. "The codes appear to have the ability to recognize the higher levels now without having to submit additional documentation." Look Forward to Better Detachment Repair Coding Beginning in January, you can count on a more appropriate code for complex retinal detachment repairs. CPT 2008 adds 67113 (Repair of complex retinal detachment [e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees], with vitrectomy and membrane peeling, may include air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens). How it works: As the code descriptor specifies, you should report 67113 for complex retinal detachment repairs that include a vitrectomy and neovascular membrane peeling. "So often a complex retinal detachment is not billed to get the fullest reimbursement," Stillman says. "Our retinal specialist performs a lot of these procedures. Not all are complex, but when one is, it will be nice to have a code to use that identifies that." Add 68816 to Your Duct-Probing Code Set When your ophthalmologist uses balloon dilation during a nasolacrimal duct probing, you'll finally have a code to pinpoint this service: 68816 (Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation). "Our physicians are always asking about the 68811/68815 and balloon insertion, so I am curious to see if the 68816 will be helpful," Stillman says. "On this one, only time will tell." Bonus: Experts expect that you'll be able to report 68816 bilaterally like you can with 68811 (Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia) and 68815 (Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent). Upgrade Your Photoscreening to Category I Say goodbye to temporary code 0065T (Ocular photoscreening with interpretation and report, bilateral). January's [...]