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Optometry Coding & Billing Alert

Reimbursement:
8 Things Your Optometry Practice Must Know About MACRA & MIPS in 2017
Good news: 2017 is a ‘Get Out of Jail Free’ card. Confused about what the ... Read more
Revenue Boost:
Is Your Practice's Optical Shop As Profitable As It Can Be?
This 6-question test says for sure. If you’re like most optometry practices, you... Read more
Revenue Boost:
Are Remakes Eating Away at Your Optical's Profits?
You don’t shell out for the cost of remakes immediately, but if you have a high re... Read more
Revenue Boost:
Fortify Optical Profits with Multiple Pair Sales, Upgrades
If your capture rate is good, congratulations! Now it’s time for your optical to m... Read more
Practice Management:
Schedule Your Way to Optimal Practice Profitability in 2017
6 ways to improve patient flow in your optometry practice. How can your practice stay ... Read more
Is Open Access Scheduling Right for Your Optometry Practice?
Make no mistake — your scheduling strategies can make or break your bottom line. (... Read more
Revenue Boost:
Dry Eye: Make the Most of Out-of-Pocket Revenue Opportunities
Diagnositic tests may not boost revenue, but they have other benefits. Insurance reimb... Read more
Collections:
Does Your Back Office Have an A/R Problem? Here's How To Tell
Focus on these 2 benchmarks. Wondering how your optometry practice is doing when it co... Read more
CPT® 2017:
Latest CPT Edition Updates Fluorescein Angiography Reporting
Changes could impact your reimbursement. Although the calendar hasn’t yet turned... Read more
Documentation:
CMS: Blepharoplasty Claims the Cause of Numerous Errors
No visual field testing? No Medicare payment, latest compliance newsletter says. You m... Read more
Billing:
Take This Advice And You'll Never Chase Down A Copay Again
Obtain signed financial responsibility form as insurance against nonpayment. Most medi... Read more
Avoid Confrontation at All Costs When Collecting Copays
Experts: Give patients a few chances to pay, then call collections. A patient flat-out... Read more
Patient Privacy:
10 Tips Help You Avoid 'Insider Threats'
Hint: Establish a baseline to spot suspicious employee behavior. Although the thought ... Read more
You Be the Expert:
Know Your Bilateral Rules
Question: Our patient was working on a building demolition and ended up with small ... Read more
Reader Question:
Avoid Modifier 50 for 92010
Question: Is 92020 (Gonioscopy [separate procedure]) inherently bilateral? Codify... Read more
Reader Question:
Know Contact Lens Rules With Keratoconus
Question: We know we can’t bill Medicare for regular refractive contact lense... Read more
Optometry Mythbuster:
Don't Perform Surgeries? Global Periods Still Apply to You
Even minor procedures have global periods associated with them. Myth: Because opt... Read more
Compliance:
This Optometrist Had to Return $150K to Medicare
Ensure that you don’t face the same fate with these FAQs. An optometrist in Okla... Read more
E/M Coding:
Are You Making This $31 Mistake?
  Determine whether you can accurately code this eye care chart.  Would th... Read more
ICD-10:
Look to 6th Digit for Most Hypotony Diagnoses
Cause of condition may ease your code selection woes. When your optometrist sees a pat... Read more
You Be the Expert:
Stamped Signatures Typically Taboo
Question: What are the specifics regarding provider signatures on claims? Is it eve... Read more
Reader Question:
Handle Potential HIPAA Breaches With Care
Question: Our receptionist was asked to fax a patient’s eye exam results to h... Read more
Preventive Services Mythbuster:
Bust These Glaucoma Screening Myths to Secure Medicare Pay
Hint: Medicare may not view a year the same way your calendar does. Your optometry pra... Read more
Compliance:
Master Co-Management to Ensure the Happiness of Patients, Doctors -- and Auditors
Never imply that co-management is an agreement to refer, experts advise. For eye care ... Read more
ICD-10:
Code to the Sixth Digit for Your Astigmatism Patients
Documentation of ‘regular’ vs. ‘irregular’ will help ease your c... Read more
You Be the Expert:
Keep Close Eye on Frequency Guidelines for 92065
Question: Our optometrist performed orthoptic training every two weeks for eight mo... Read more
Reader Question:
Don't Let Time Crunch Cost You Money
Question: I read your article last month where you advised asking patients for thei... Read more
Reader Question:
Who Qualifies As a Business Associate?
Question: I have read about business associate agreements (BAAs) in past issues of ... Read more
Vision Benefits:
Optometrist Is in Driver's Seat When Managing Annual Vision Benefit
Ensure that the OD is aware of the patient’s benefit before recommending contacts ... Read more
Billing:
Consider These 3 Key Takeaways Before You Hire A Billing Company
Hint: Compliance is as important as billing and coding when reviewing potential outsourc... Read more
ICD-10:
Help Make Sense of Your Eye Care Claims With 'Z' Codes
These diagnoses can support screenings and much more. Remember the ‘V’ cod... Read more
These Z Codes Can Make Your Claims Shine
Eye care practices that are unfamiliar with additional Z codes beyond the ones mentioned... Read more
Practice Management:
Consider These Tips When Discharging A Patient From Your Practice
Remember to use certified mail whenever possible. Your patients are your bread and but... Read more
You Be the Expert:
Don't Look to 90863 for Med Management
Question: Which code(s) should we report to describe our services providing medicat... Read more
Reader Question:
Replace Modifier 50 With Modifier 26 in This Scenario
Question: Our optometrist calculated IOL power in both eyes, and we reported 76519-... Read more
Reader Question:
Check CCI Before You Bill
Question: We are having trouble collecting for both 92250 and 92133 when the optome... Read more
Correct Coding Initiative:
Don't Get Burned by These New CCI Edits
Experts advise on the best way to collect when CCI comes calling. Sometimes it seems l... Read more
Collections:
Let Your No-Show Policy Speak for You When Patients Skip Appointment
A robust policy will prevent write-offs for your optometry practice. When patients don... Read more
Practice Management:
At First Sight: Your Reception Area Sets the Tone for Your Office
Don’t make a bad impression when patients walk through your front door. When a p... Read more
Patient Population Should Drive Reception Decor
Pediatric optometrists will have different waiting rooms than those seeing cataract pati... Read more
You Be the Expert:
Contract Verifications Don't Automatically Lead to Audits
Question: Our medical office recently received a contact verification email from OC... Read more
Reader Question:
Look to Documentation for E/M Clues
Question: Our optometrist removed a foreign body from a patient’s eye. Can we... Read more
Reader Question:
P&L Statements Could Offer Treasure Trove of Information
Question: I read your article on benchmarking last month with great interest (Vol. ... Read more
Reader Question:
Check Reason for Visit When Looking at 99050
Question: Can we report 99050 for a walk-in patient who came to our clinic after we... Read more
Ocular Surface Disease:
3 Tips Help You Collect When Treating Dry Eyes in Content Lens Patients
Hint: Treating OSD is completely separate from training patients on lens care. Most co... Read more
Benchmarking:
Majority of Optometrists' Ophthalmic Codes Nationwide Are Level 4
Use this carrier’s data to compare your billings to other optometrists across the ... Read more
Palmetto Weighs in:
E/M Codes Vs. Eye Codes
Many optometry practices struggle with the question of to use standard E/M codes for the... Read more
Diagnosis Dilemma
The Palmetto auditors looked at whether diagnosis codes were submitted to the highest le... Read more
ICD-10:
3 Tips Help Your Optometry Claims Sail Through After ICD-10 Grace Period Ends
You’ve got three months left to simply code in the right ‘family.’ I... Read more
Here's How to Track Your ICD-10 Progress, CMS-Style
Not sure where you stand in terms of your ICD-10 progress at this point? CMS offers deta... Read more
You Be the Expert:
Does A Letter Count as A 'Medical Record?'
Question: Our optometrist circled 99213 on his chart, but the only note in the reco... Read more
Reader Question:
Request Written Medical Policy
Question: I contacted my insurer and asked how they prefer me to submit codes for a... Read more
Reader Question:
Some Health Apps Must Be HIPAA Compliant
Question: Our optometrists are using more and more apps for a variety of reasons, i... Read more
ICD-10:
Expanded Dx Codes May Be Coming for Diabetes With Ophthalmic Complications
Also, look for new retinal vein occlusion, AMD, glaucoma, and amblyopia options. ... Read more
Modifiers:
Master These Eye Modifiers and Keep Your Claims Crystal-Clear
Do you know which modifiers may affect your payments? Even if you’re brand-new t... Read more
Privacy:
Sneak Peek: Here's What to Expect in Your Next HIPAA Audit
Ensure that your program discusses how to cover these details to prep for an audit. Do... Read more
You Be the Expert:
Refraction Without Prescription
Question: Is it appropriate to bill a patient for 92015 even if we don’t give... Read more
Reader Question:
Put Locum Tenens Rules to Work for You Using These Tips
Question: Our practice recently hired a locum tenens (LT) physician to fill in for ... Read more
Reader Question:
Base Coding on HEM, Not Visit Type
Question: I have a provider that saw a patient on Monday and coded a 99214. He then... Read more
Diagnostics:
Could One of These Myths Be Sinking Your EO Claims?
Extended ophthalmology coding has a few sticking points – read on to smooth your w... Read more
Glaucoma Coding:
Part II: Zoom In on Glaucoma Screening, Testing Rules
Do you know which codes should only be used with Medicare patients? Last issue, we bro... Read more
Practice Management:
Monitor Claims to Max Out Your Optometrists' Pay
Keep your AR up-to-date. You’re up-to-date on coding changes, you’ve educa... Read more
HIPAA:
Report: Many Practices Are Unprepared for Coming HIPAA Audits
No privacy officer? Then you aren’t HIPAA compliant. As Part B practices nationw... Read more
You Be the Expert:
Foreign Body Sensation With No Foreign Body?
Question: What is proper diagnosis coding if a patient comes in with a foreign-body... Read more
Reader Question:
Ensure Valid Provider Signatures
Question: I’m having trouble getting my optometrists to sign their claim form... Read more
Reader Question:
Make Sure Patients Understand EOB's Purpose
Question: We often get patients who call the practice with questions about their ex... Read more
Dry Eye:
Plenty of Dry Eyes in the House - Here's How to Safeguard Your Reimbursement
Nearly $150 is at stake each time. With nearly 78.5 million Americans suffering from d... Read more
Glaucoma Coding:
Part I: Watch Risk Factors, Screening Rules to Navigate Glaucoma Coding Angles
Tip: Specify which eye is affected to nail the proper ICD-10 code. According to the Gl... Read more
Revenue:
Get Better Information from Patients to Thwart Billing Mistakes
Tip: Don’t just ask, “Has your insurance information changed?” We&rs... Read more
You Be the Expert:
Epilation of Lashes by Forceps
Question: The optometrist used forceps to remove an ingrown eyelash. What CPT® ... Read more
Reader Question:
Just One Dx Code for Diabetic Retinopathy
Question: For a diagnosis of diabetic retinopathy with ICD-10 codes, do we still ha... Read more
Reader Question:
Charge Patient Difference for Deluxe Frames
Question: What are the criteria to bill for deluxe frames with V2025 for a post-cat... Read more
Reader Question:
Use Split Visit Rules to Duck 15 Percent Pay Cut
Question: I’ve heard nurse practitioners (NPs) and other providers talk about... Read more
Reader Question:
Get Consent Before Disclosing Test Results
Question: When an employer pays our office to perform vision tests, can we disclose... Read more
Diagnostic Tests:
Part III: SCODI, FA, Fundus Photography, and Gonioscopy Round Out Your Diagnostic Coding Arsenal
Warning: Don’t get tripped up by tricky bilateral rules. In the last issue of Op... Read more
Compliance:
Target Your EHRs for Scrutiny
Watch incentive payments, too. HIPAA enforcement just keeps getting tougher — th... Read more
Modifiers:
Keep PC/TC Rules in Mind for Tech's Work in Ophthalmic Test Claims
Hint: Look for the modifier indicator in the Medicare fee schedule for guidance. Many ... Read more
You Be the Expert:
Low Vision Aids
Question: Our practice is considering dispensing low-vision aids. How should we cod... Read more
Reader Question:
Also Report Endophthalmitis Cause
Question: The ICD-10 description for endophthalmitis now says to “use additio... Read more
Reader Question:
Include Single Tonometry in General Ophthalmological Services
Question: Our ophthalmologist renders single-episode tonometry services on her pati... Read more
Reader Question:
Medicare Won't Pay? Get ABN Anyway
Question: Are patients undergoing keratoconus workup or contact lens fitting still ... Read more
Diagnostic Tests:
Part II: Refraction, Topography, Visual Fields -- Keep Your Diagnostic Test Coding On Point
Follow these expert tips for CPT® 92015, 92025, and 92081-92083. In the last issue... Read more
ICD-10:
H47 Family Holds the ICD-10 Answers for Optic Chiasm, Visual Cortex Disorders
Check detailed codes for side specificity. If you’re in a neuro-ophthalmology pr... Read more
Compliance:
Know Your Vulnerabilities Before Auditors Come Knocking
Focus on these hotspots to reduce audit risk. Even if your practice puts the stronges... Read more
Electronic Health Records:
Know How You Can Stay Abreast of Your EHR System Using These 3 Tips
Surprisingly, EHRs adding to difficulties instead of reducing workload, says study. If... Read more
You Be the Expert:
Low-Risk Glaucoma Screenings
Question: Our office sometimes performs glaucoma screenings for patients who don&rs... Read more
Reader Question:
Determine PFSH for E/M Choice
Question: I have a note for an office visit that clearly indicates a comprehensive ... Read more
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