Ophthalmology and Optometry Coding Alert

Know when to use RT/LT and when to rely on modifier 50. Don't let tricky prefixes stand in the way of maximum reimbursement for your practice. Read on to learn when you can expect deserved double payment for a service and how to ethically make the most of modifiers. Dispel Prefix Confusion The most common mistake new ophthalmology coders make is tripping over the unilateral-bilateral conundrum. Here is the breakdown: Unilateral means there is a 100 percent allowance per eye. In effect, two unilateral procedures results in a payment equal to 200 percent of the fee, explained Raequell Duran, CPC, president of Practice Solutions, a coding, compliance, and reimbursement consulting firm based in Santa Barbara, Calif., at The Coding Institute's December conference in Orlando. Bilateral means there is a 100 percent allowance for both eyes. In other words, you can only bill for a bilateral service one time. Bottom line: [...]