Ophthalmology and Optometry Coding Alert

Heed these documentation and modifier tips to ethically earn an extra $160 for after-cataract services. Ophthalmologists perform thousands of cataract surgeries each year, which can lead to a fair share of post-op complications that can be difficult to code. Fair reimbursement for postoperative procedures for complications -- such as after-cataracts -- depends on the direction that follows on airtight documentation and skillful modifier use. Beware PCO Within Global The problem: Posterior capsule opacification (PCO), also known as an "after-cataract," is one of the most common problems following cataract surgery; a report from the Surgeon General found that 41 percent of patients develop PCO within 48 months after cataract surgery. In PCO, residual lens epithelial cells, left behind during the original surgery, proliferate and migrate. The membrane behind the new inserted intraocular lens thickens, blurring the vision. Diagnosis: ICD-9 code 366.53 (After-cataract, obscuring vision). (Note: This diagnosis code will change with ICD-10 -- see [...]