Ophthalmology and Optometry Coding Alert

Key: The right ICD-9 codes and modifiers can bring your practice $1700 for bilateral PRP.A diabetic retinopathy patient usually undergoes several laser treatments. But because the CPT® descriptions for those treatments say "one or more sessions," you can only code the first procedure, right?Not quite, experts say. The answer depends on what kind of diabetic retinopathy (DR) the patient has, as well as what method of treatment the ophthalmologist uses and whether one or both eyes are affected.Report Edema Diagnosis for Background DRDR patients are usually facing a series of laser treatments, with either a focal laser (67210, Destruction of localized lesion of retina [e.g., macular edema, tumors], 1 or more sessions; photocoagulation) or panretinal photocoagulation (PRP) (67228, Treatment of extensive or progressive retinopathy, 1 or more sessions; [e.g., diabetic retinopathy], photocoagulation). Sometimes, however, ophthalmologists need to use both.To navigate the DR maze, you first have to determine the kind [...]