92015 billing

msvo

New
Messages
2
Best answers
0
Hello, I am new to Optometry coding.
I have an encounter where the patient came in with complaint of a headache. The Optometrist did the refraction and determined the patient did not need glasses.
Is a new glasses prescription need to bill 92015?
 
Messages
190
Best answers
0
no, if the provider did a refraction you can submit a refraction with the office visit. refractions cannot go by themselves
 

Cheezum51

Expert
Messages
280
Best answers
0
The first reply you received is correct. One addition to the above. Hardly any insurers pay for the 92015 refraction. Therefore, you should collect the refraction fee from the patient at the time of exam. File the 92015, with the refractive codes, and if by some chance the carrier does pay, then reimburse the patient accordingly. If you wait for the the insurer to deny the 92015, I can guarantee you that the majority of patients will not pay the fee when you bill them or take up hours of your time complaining about what you did "wrong" to cause the 92015 not to be paid.

Your front desk check out staff should tell the patients that the 92015 isn't paid by their major medical so they will have to pay at the time of the exam but let them know that it will be filed in case they have a plan which will cover it.

Tom Cheezum, OD, CPC, COPC
 
Top